05D2296735 CLIA NUMBER - WALGREENS 01079

Laboratory Demographics

  • CLIA Code: 05D2296735
  • Facility Name: WALGREENS 01079
  • Facility Address: 1700 E VISTA CHINO
    PALM SPRINGS, CA
    ZIP 92262
  • Facility Phone: 760 864-1516
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VYHAN NGUYEN
  • NPI Number: 1497827190
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2296735
LAB Type Pharmacy
Facility Name WALGREENS 01079
Street 1700 E VISTA CHINO
City PALM SPRINGS
State CA
ZIP 92262
Phone 760 864-1516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Pharmacy
Lab Director VYHAN NGUYEN

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This page was last updated on: 6/4/2025