05D2295973 CLIA NUMBER - WALGREENS 05182

Laboratory Demographics

  • CLIA Code: 05D2295973
  • Facility Name: WALGREENS 05182
  • Facility Address: 60 N HIGHLAND SPRINGS AVE
    BANNING, CA
    ZIP 92220
  • Facility Phone: 915 845-5984
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HONG KIM GA AE
  • NPI Number: 1750396032
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295973
LAB Type Pharmacy
Facility Name WALGREENS 05182
Street 60 N HIGHLAND SPRINGS AVE
City BANNING
State CA
ZIP 92220
Phone 915 845-5984
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 HONG KIM GA AE

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