05D2302162 CLIA NUMBER - WALGREENS 09137

Laboratory Demographics

  • CLIA Code: 05D2302162
  • Facility Name: WALGREENS 09137
  • Facility Address: 14250 PRAIRIE AVE
    HAWTHORNE, CA
    ZIP 90250
  • Facility Phone: 310 978-9167
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAROLYN T. PHAM
  • NPI Number: 1235144247
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302162
LAB Type Pharmacy
Facility Name WALGREENS 09137
Street 14250 PRAIRIE AVE
City HAWTHORNE
State CA
ZIP 90250
Phone 310 978-9167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2024
Certificate Expiration Date 4/3/2026
Facility Type Pharmacy
Lab Director CAROLYN T. PHAM

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