05D2300630 CLIA NUMBER - WALGREENS 11440

Laboratory Demographics

  • CLIA Code: 05D2300630
  • Facility Name: WALGREENS 11440
  • Facility Address: 2331 S ATLANTIC BLVD
    MONTEREY PARK, CA
    ZIP 91754
  • Facility Phone: 323 526-9102
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDER C. TAN
  • NPI Number: 1124226121
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2300630
LAB Type Pharmacy
Facility Name WALGREENS 11440
Street 2331 S ATLANTIC BLVD
City MONTEREY PARK
State CA
ZIP 91754
Phone 323 526-9102
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 ALEXANDER C. TAN

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