05D2222008 CLIA NUMBER - WALGREENS #10366

Laboratory Demographics

  • CLIA Code: 05D2222008
  • Facility Name: WALGREENS #10366
  • Facility Address: 1186 CALIMESA BLVD
    CALIMESA, CA
    ZIP 92320
  • Facility Phone: 909 795-1147
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NOUR DABBAS
  • NPI Number: 1285866061
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2222008
LAB Type Pharmacy
Facility Name WALGREENS #10366
Street 1186 CALIMESA BLVD
City CALIMESA
State CA
ZIP 92320
Phone 909 795-1147
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director NOUR DABBAS

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