05D2256671 CLIA NUMBER - WALGREENS #10481

Laboratory Demographics

  • CLIA Code: 05D2256671
  • Facility Name: WALGREENS #10481
  • Facility Address: 265 W FOREST AVE
    COALINGA, CA
    ZIP 93210
  • Facility Phone: 550 934-0461
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELVIN LE
  • NPI Number: 1891941944
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2256671
LAB Type Pharmacy
Facility Name WALGREENS #10481
Street 265 W FOREST AVE
City COALINGA
State CA
ZIP 93210
Phone 550 934-0461
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Pharmacy
Lab Director KELVIN LE

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