05D2222015 CLIA NUMBER - WALGREENS #11653

Laboratory Demographics

  • CLIA Code: 05D2222015
  • Facility Name: WALGREENS #11653
  • Facility Address: 1320 ENCINITAS BLVD
    ENCINITAS, CA
    ZIP 92024
  • Facility Phone: 760 942-2018
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PARISA OURMAZDI
  • NPI Number: 1083941637
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2222015
LAB Type Pharmacy
Facility Name WALGREENS #11653
Street 1320 ENCINITAS BLVD
City ENCINITAS
State CA
ZIP 92024
Phone 760 942-2018
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 PARISA OURMAZDI

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