05D2256674 CLIA NUMBER - WALGREENS #07990

Laboratory Demographics

  • CLIA Code: 05D2256674
  • Facility Name: WALGREENS #07990
  • Facility Address: 1745 UNIVERSITY AVE
    RIVERSIDE, CA
    ZIP 92507
  • Facility Phone: 951 684-5661
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ESTHER Y. KIM
  • NPI Number: 1770868580
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2256674
LAB Type Pharmacy
Facility Name WALGREENS #07990
Street 1745 UNIVERSITY AVE
City RIVERSIDE
State CA
ZIP 92507
Phone 951 684-5661
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 ESTHER Y. KIM

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