05D2302038 CLIA NUMBER - WALGREENS 13859

Laboratory Demographics

  • CLIA Code: 05D2302038
  • Facility Name: WALGREENS 13859
  • Facility Address: 925 ORANGE AVE
    CORONADO, CA
    ZIP 92118
  • Facility Phone: 619 435-6354
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM K. LANDEIS
  • NPI Number: 1962753061
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302038
LAB Type Pharmacy
Facility Name WALGREENS 13859
Street 925 ORANGE AVE
City CORONADO
State CA
ZIP 92118
Phone 619 435-6354
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 WILLIAM K. LANDEIS

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