05D2301959 CLIA NUMBER - WALGREENS 13813

Laboratory Demographics

  • CLIA Code: 05D2301959
  • Facility Name: WALGREENS 13813
  • Facility Address: 160 DIAMOND DR
    LAKE ELSINORE, CA
    ZIP 92530
  • Facility Phone: 951 674-3562
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KALEB C. LAI
  • NPI Number: 1285921635
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301959
LAB Type Pharmacy
Facility Name WALGREENS 13813
Street 160 DIAMOND DR
City LAKE ELSINORE
State CA
ZIP 92530
Phone 951 674-3562
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 KALEB C. LAI

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