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05D2298067 CLIA NUMBER - WALGREENS 05591

Laboratory Demographics

CLIA Number: 05D2298067

Facility Name: WALGREENS 05591

Facility Address:
24930 WESTERN AVE
HARBOR CITY, CA
ZIP 90710
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Facility Phone Number: 310 891-1264

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1003821380

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 05D2298067
LAB Type Pharmacy
Facility Name WALGREENS 05591
Street 24930 WESTERN AVE
City HARBOR CITY
State CA
ZIP 90710
Phone 310 891-1264
CertificateType 4
CertificateEffectiveDate 1/26/2024
CertificateExpirationDate 1/25/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024