05D2301629 CLIA NUMBER - WALGREENS 10738

Laboratory Demographics

  • CLIA Code: 05D2301629
  • Facility Name: WALGREENS 10738
  • Facility Address: 140 W LOS ANGELES AVE
    MOORPARK, CA
    ZIP 93021
  • Facility Phone: 805 529-9601
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICK MIRZAKHANIAN
  • NPI Number: 1013183219
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2301629
LAB Type Pharmacy
Facility Name WALGREENS 10738
Street 140 W LOS ANGELES AVE
City MOORPARK
State CA
ZIP 93021
Phone 805 529-9601
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Pharmacy
Lab Director PATRICK MIRZAKHANIAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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