05D2259218 CLIA NUMBER - WALGREENS #07303

Laboratory Demographics

  • CLIA Code: 05D2259218
  • Facility Name: WALGREENS #07303
  • Facility Address: 100 W ONTARIO AVE
    CORONA, CA
    ZIP 92882
  • Facility Phone: 951 582-9551
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AGBOMMA ORDU
  • NPI Number: 1609883602
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2259218
LAB Type Pharmacy
Facility Name WALGREENS #07303
Street 100 W ONTARIO AVE
City CORONA
State CA
ZIP 92882
Phone 951 582-9551
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Pharmacy
Lab Director AGBOMMA ORDU

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