05D2297213 CLIA NUMBER - WALGREENS 05848

Laboratory Demographics

  • CLIA Code: 05D2297213
  • Facility Name: WALGREENS 05848
  • Facility Address: 20505 SHERMAN WAY
    CANOGA PARK, CA
    ZIP 91306
  • Facility Phone: 818 719-6599
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELISSA KIM
  • NPI Number: 1669487997
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297213
LAB Type Pharmacy
Facility Name WALGREENS 05848
Street 20505 SHERMAN WAY
City CANOGA PARK
State CA
ZIP 91306
Phone 818 719-6599
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 MELISSA KIM

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