05D2297169 CLIA NUMBER - WALGREENS 05300

Laboratory Demographics

  • CLIA Code: 05D2297169
  • Facility Name: WALGREENS 05300
  • Facility Address: 27951 BASELINE ST
    HIGHLAND, CA
    ZIP 92346
  • Facility Phone: 909 864-5701
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATHURIN ACHIRI
  • NPI Number: 1740295021
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297169
LAB Type Pharmacy
Facility Name WALGREENS 05300
Street 27951 BASELINE ST
City HIGHLAND
State CA
ZIP 92346
Phone 909 864-5701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Pharmacy
Lab Director MATHURIN ACHIRI

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