05D2299577 CLIA NUMBER - WALGREENS 06187

Laboratory Demographics

  • CLIA Code: 05D2299577
  • Facility Name: WALGREENS 06187
  • Facility Address: 11950 VALLEY VIEW ST
    GARDEN GROVE, CA
    ZIP 92845
  • Facility Phone: 714 893-4196
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PENDLETON THAN
  • NPI Number: 1306851696
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2299577
LAB Type Pharmacy
Facility Name WALGREENS 06187
Street 11950 VALLEY VIEW ST
City GARDEN GROVE
State CA
ZIP 92845
Phone 714 893-4196
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Pharmacy
Lab Director PENDLETON THAN

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