05D2298605 CLIA NUMBER - WALGREENS 05372

Laboratory Demographics

  • CLIA Code: 05D2298605
  • Facility Name: WALGREENS 05372
  • Facility Address: 16108 FOOTHILL BLVD
    FONTANA, CA
    ZIP 92335
  • Facility Phone: 909 357-6900
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TINA TRAN
  • NPI Number: 1174538441
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2298605
LAB Type Pharmacy
Facility Name WALGREENS 05372
Street 16108 FOOTHILL BLVD
City FONTANA
State CA
ZIP 92335
Phone 909 357-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Pharmacy
Lab Director TINA TRAN

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