05D2301252 CLIA NUMBER - WALGREENS 07070

Laboratory Demographics

  • CLIA Code: 05D2301252
  • Facility Name: WALGREENS 07070
  • Facility Address: 4009 LINCOLN BLVD
    MARINA DEL REY, CA
    ZIP 90292
  • Facility Phone: 310 823-7152
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON MAY
  • NPI Number: 1295740389
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301252
LAB Type Pharmacy
Facility Name WALGREENS 07070
Street 4009 LINCOLN BLVD
City MARINA DEL REY
State CA
ZIP 90292
Phone 310 823-7152
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Pharmacy
Lab Director BRANDON MAY

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