05D2300306 CLIA NUMBER - WALGREENS 06904

Laboratory Demographics

  • CLIA Code: 05D2300306
  • Facility Name: WALGREENS 06904
  • Facility Address: 535 S PACIFIC COAST HWY
    REDONDO BEACH, CA
    ZIP 90277
  • Facility Phone: 310 540-2228
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHUONG LE
  • NPI Number: 1215942503
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2300306
LAB Type Pharmacy
Facility Name WALGREENS 06904
Street 535 S PACIFIC COAST HWY
City REDONDO BEACH
State CA
ZIP 90277
Phone 310 540-2228
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Pharmacy
Lab Director PHUONG LE

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