05D2223082 CLIA NUMBER - WALGREENS #09882

Laboratory Demographics

  • CLIA Code: 05D2223082
  • Facility Name: WALGREENS #09882
  • Facility Address: 331 N PACIFIC COAST HWY
    EL SEGUNDO, CA
    ZIP 90245
  • Facility Phone: 310 640-9651
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA LUO
  • NPI Number: 1174717045
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2223082
LAB Type Pharmacy
Facility Name WALGREENS #09882
Street 331 N PACIFIC COAST HWY
City EL SEGUNDO
State CA
ZIP 90245
Phone 310 640-9651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director JESSICA LUO

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