05D2299101 CLIA NUMBER - WALGREENS 05528

Laboratory Demographics

  • CLIA Code: 05D2299101
  • Facility Name: WALGREENS 05528
  • Facility Address: 4041 N SIERRA WAY
    SAN BERNARDINO, CA
    ZIP 92407
  • Facility Phone: 909 881-1813
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN URBANEK
  • NPI Number: 1538174818
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2299101
LAB Type Pharmacy
Facility Name WALGREENS 05528
Street 4041 N SIERRA WAY
City SAN BERNARDINO
State CA
ZIP 92407
Phone 909 881-1813
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Pharmacy
Lab Director BRIAN URBANEK

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