05D2297640 CLIA NUMBER - WALGREENS 01254

Laboratory Demographics

  • CLIA Code: 05D2297640
  • Facility Name: WALGREENS 01254
  • Facility Address: 44100 JEFFERON ST
    INDIO, CA
    ZIP 92201
  • Facility Phone: 760 772-2759
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATHERIN Y. LE
  • NPI Number: 1023051638
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297640
LAB Type Pharmacy
Facility Name WALGREENS 01254
Street 44100 JEFFERON ST
City INDIO
State CA
ZIP 92201
Phone 760 772-2759
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Pharmacy
Lab Director KATHERIN Y. LE

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