05D2263080 CLIA NUMBER - WALGREENS #06640

Laboratory Demographics

  • CLIA Code: 05D2263080
  • Facility Name: WALGREENS #06640
  • Facility Address: 550 S GRAND AVE
    GLENDORA, CA
    ZIP 91741
  • Facility Phone: 626 857-0633
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: BILL C. CHAN
  • NPI Number: 1114932407
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2263080
LAB Type Other - CLINIC
Facility Name WALGREENS #06640
Street 550 S GRAND AVE
City GLENDORA
State CA
ZIP 91741
Phone 626 857-0633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Other - CLINIC
Lab Director BILL C. CHAN

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