05D2300603 CLIA NUMBER - WALGREENS 09136

Laboratory Demographics

  • CLIA Code: 05D2300603
  • Facility Name: WALGREENS 09136
  • Facility Address: 1625 W SUNSET BLVD
    LOS ANGELES, CA
    ZIP 90026
  • Facility Phone: 213 482-9286
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PANG CHEN
  • NPI Number: 1427063437
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2300603
LAB Type Pharmacy
Facility Name WALGREENS 09136
Street 1625 W SUNSET BLVD
City LOS ANGELES
State CA
ZIP 90026
Phone 213 482-9286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Pharmacy
Lab Director PANG CHEN

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