05D2299443 CLIA NUMBER - WALGREENS 06399

Laboratory Demographics

  • CLIA Code: 05D2299443
  • Facility Name: WALGREENS 06399
  • Facility Address: 58133 29 PALMS HWY
    YUCCA VALLEY, CA
    ZIP 92284
  • Facility Phone: 760 369-4615
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANG W. KANG
  • NPI Number: 1992710289
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2299443
LAB Type Pharmacy
Facility Name WALGREENS 06399
Street 58133 29 PALMS HWY
City YUCCA VALLEY
State CA
ZIP 92284
Phone 760 369-4615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2024
Certificate Expiration Date 2/20/2026
Facility Type Pharmacy
Lab Director SANG W. KANG

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