05D2298612 CLIA NUMBER - WALGREENS 05478

Laboratory Demographics

CLIA Number: 05D2298612

Facility Name: WALGREENS 05478

Facility Address:
6701 CANELIAN ST
RANCHO CUCAMONGA, CA
ZIP 91701
Get Directions

Facility Phone Number: 909 581-1157

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1548275829

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	05D2298612
LAB Type	Pharmacy
Facility Name	WALGREENS 05478
Street	6701 CANELIAN ST
City	RANCHO CUCAMONGA
State	CA
ZIP	91701
Phone	909 581-1157
CertificateType	4
CertificateEffectiveDate	2/5/2024
CertificateExpirationDate	2/4/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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