05D2300330 CLIA NUMBER - WALGREENS 15388

Laboratory Demographics

  • CLIA Code: 05D2300330
  • Facility Name: WALGREENS 15388
  • Facility Address: 301 UNIVERSITY AVE
    SAN DIEGO, CA
    ZIP 92103
  • Facility Phone: 619 325-0423
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PARDIS REZAEIPOUR
  • NPI Number: 1073946489
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2300330
LAB Type Pharmacy
Facility Name WALGREENS 15388
Street 301 UNIVERSITY AVE
City SAN DIEGO
State CA
ZIP 92103
Phone 619 325-0423
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 PARDIS REZAEIPOUR

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