05D2301669 CLIA NUMBER - WALGREENS 07230

Laboratory Demographics

  • CLIA Code: 05D2301669
  • Facility Name: WALGREENS 07230
  • Facility Address: 495 E HOLT AVE
    POMONA, CA
    ZIP 91767
  • Facility Phone: 909 469-9534
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NANCY PEREZ
  • NPI Number: 1992712954
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301669
LAB Type Pharmacy
Facility Name WALGREENS 07230
Street 495 E HOLT AVE
City POMONA
State CA
ZIP 91767
Phone 909 469-9534
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 NANCY PEREZ

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