05D2300552 CLIA NUMBER - WALGREENS 12460

Laboratory Demographics

  • CLIA Code: 05D2300552
  • Facility Name: WALGREENS 12460
  • Facility Address: 617 W 7TH ST
    LOS ANGELES, CA
    ZIP 90017
  • Facility Phone: 213 694-2880
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIN J. OH
  • NPI Number: 1386968758
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2300552
LAB Type Pharmacy
Facility Name WALGREENS 12460
Street 617 W 7TH ST
City LOS ANGELES
State CA
ZIP 90017
Phone 213 694-2880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Pharmacy
Lab Director ERIN J. OH

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