05D2084539 CLIA NUMBER - WALGREENS #15930

Laboratory Demographics

  • CLIA Code: 05D2084539
  • Facility Name: WALGREENS #15930
  • Facility Address: 2050 GLENOAKS BLVD
    SAN FERNANDO, CA
    ZIP 91340
  • Facility Phone: 818 741-1103
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN O. OLUKEMI
  • NPI Number: 1447667118
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2084539
LAB Type Pharmacy
Facility Name WALGREENS #15930
Street 2050 GLENOAKS BLVD
City SAN FERNANDO
State CA
ZIP 91340
Phone 818 741-1103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Pharmacy
Lab Director JOHN O. OLUKEMI

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This page was last updated on: 9/29/2025