05D2302035 CLIA NUMBER - WALGREENS 07629

Laboratory Demographics

  • CLIA Code: 05D2302035
  • Facility Name: WALGREENS 07629
  • Facility Address: 5005 BALL RD
    CYPRESS, CA
    ZIP 90630
  • Facility Phone: 714 886-1079
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LOIS M. SAKAMOTO
  • NPI Number: 1134134414
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302035
LAB Type Pharmacy
Facility Name WALGREENS 07629
Street 5005 BALL RD
City CYPRESS
State CA
ZIP 90630
Phone 714 886-1079
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 LOIS M. SAKAMOTO

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