05D2296739 CLIA NUMBER - WALGREENS 04757

Laboratory Demographics

  • CLIA Code: 05D2296739
  • Facility Name: WALGREENS 04757
  • Facility Address: 42010 WASHINGTON ST
    INDIO, CA
    ZIP 92203
  • Facility Phone: 760 772-9122
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RONALD CLOYD
  • NPI Number: 1740295013
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2296739
LAB Type Pharmacy
Facility Name WALGREENS 04757
Street 42010 WASHINGTON ST
City INDIO
State CA
ZIP 92203
Phone 760 772-9122
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 RONALD CLOYD

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