05D2259222 CLIA NUMBER - WALGREENS #04382

Laboratory Demographics

  • CLIA Code: 05D2259222
  • Facility Name: WALGREENS #04382
  • Facility Address: 795 E FOOTHILL BLVD
    POMONA, CA
    ZIP 91767
  • Facility Phone: 909 624-3017
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELEANOR BICERA
  • NPI Number: 1669486999
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2259222
LAB Type Pharmacy
Facility Name WALGREENS #04382
Street 795 E FOOTHILL BLVD
City POMONA
State CA
ZIP 91767
Phone 909 624-3017
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 ELEANOR BICERA

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