05D2222010 CLIA NUMBER - WALGREENS #10420

Laboratory Demographics

  • CLIA Code: 05D2222010
  • Facility Name: WALGREENS #10420
  • Facility Address: 42107 BIG BEAR BLVD
    BIG BEAR LAKE, CA
    ZIP 92315
  • Facility Phone: 909 866-1076
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONNY ZHOU
  • NPI Number: 1831361450
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2222010
LAB Type Pharmacy
Facility Name WALGREENS #10420
Street 42107 BIG BEAR BLVD
City BIG BEAR LAKE
State CA
ZIP 92315
Phone 909 866-1076
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 JONNY ZHOU

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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