05D2258584 CLIA NUMBER - WALGREENS #10368

Laboratory Demographics

  • CLIA Code: 05D2258584
  • Facility Name: WALGREENS #10368
  • Facility Address: 2261 W ESPLANADE AVE
    SAN JACINTO, CA
    ZIP 92582
  • Facility Phone: 951 487-2383
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SEAN YU
  • NPI Number: 1568655983
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2258584
LAB Type Pharmacy
Facility Name WALGREENS #10368
Street 2261 W ESPLANADE AVE
City SAN JACINTO
State CA
ZIP 92582
Phone 951 487-2383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Pharmacy
Lab Director SEAN YU

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