05D2300747 CLIA NUMBER - WALGREENS 06972

Laboratory Demographics

  • CLIA Code: 05D2300747
  • Facility Name: WALGREENS 06972
  • Facility Address: 150 S GRAND AVE
    COVINA, CA
    ZIP 91724
  • Facility Phone: 626 966-8497
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GLENN M. CHANG
  • NPI Number: 1306851498
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2300747
LAB Type Pharmacy
Facility Name WALGREENS 06972
Street 150 S GRAND AVE
City COVINA
State CA
ZIP 91724
Phone 626 966-8497
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Pharmacy
Lab Director GLENN M. CHANG

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