05D2258591 CLIA NUMBER - WALGREENS #06903

Laboratory Demographics

  • CLIA Code: 05D2258591
  • Facility Name: WALGREENS #06903
  • Facility Address: 5829 LAKEWOOD BOULEVARD
    LAKEWOOD, CA
    ZIP 90712
  • Facility Phone: 562 817-5690
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: SASHIDARAN MOODLEY
  • NPI Number: 1770598047
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2258591
LAB Type Other - CLINIC
Facility Name WALGREENS #06903
Street 5829 LAKEWOOD BOULEVARD
City LAKEWOOD
State CA
ZIP 90712
Phone 562 817-5690
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 Other - CLINIC
Lab Director SASHIDARAN MOODLEY

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