05D2295972 CLIA NUMBER - WALGREENS 07654

Laboratory Demographics

  • CLIA Code: 05D2295972
  • Facility Name: WALGREENS 07654
  • Facility Address: 14102 RAMONA BLVD
    BALDWIN PARK, CA
    ZIP 91706
  • Facility Phone: 626 337-1082
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RUBEN MALDONADO
  • NPI Number: 1811142235
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295972
LAB Type Pharmacy
Facility Name WALGREENS 07654
Street 14102 RAMONA BLVD
City BALDWIN PARK
State CA
ZIP 91706
Phone 626 337-1082
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Pharmacy
Lab Director RUBEN MALDONADO

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