05D2222601 CLIA NUMBER - WALGREENS #07976

Laboratory Demographics

CLIA Number: 05D2222601

Facility Name: WALGREENS #07976

Facility Address:
800 E LUGONIA AVE
REDLANDS, CA
ZIP 92374
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Facility Phone Number: 909 307-6964

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1659456507

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	05D2222601
LAB Type	Pharmacy
Facility Name	WALGREENS #07976
Street	800 E LUGONIA AVE
City	REDLANDS
State	CA
ZIP	92374
Phone	909 307-6964
CertificateType	4
CertificateEffectiveDate	4/29/2023
CertificateExpirationDate	4/28/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024