05D2301944 CLIA NUMBER - WALGREENS 12915

Laboratory Demographics

  • CLIA Code: 05D2301944
  • Facility Name: WALGREENS 12915
  • Facility Address: 7195 BROADWAY
    LEMON GROVE, CA
    ZIP 91945
  • Facility Phone: 619 433-0172
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL SALDIVAR
  • NPI Number: 1487900429
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301944
LAB Type Pharmacy
Facility Name WALGREENS 12915
Street 7195 BROADWAY
City LEMON GROVE
State CA
ZIP 91945
Phone 619 433-0172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Pharmacy
Lab Director DANIEL SALDIVAR

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