05D2302326 CLIA NUMBER - WALGREENS 09389

Laboratory Demographics

  • CLIA Code: 05D2302326
  • Facility Name: WALGREENS 09389
  • Facility Address: 310 SYCAMORE AVE
    VISTA, CA
    ZIP 92083
  • Facility Phone: 760 630-5723
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LE G. HUA
  • NPI Number: 1629171038
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302326
LAB Type Pharmacy
Facility Name WALGREENS 09389
Street 310 SYCAMORE AVE
City VISTA
State CA
ZIP 92083
Phone 760 630-5723
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2024
Certificate Expiration Date 4/8/2026
Facility Type Pharmacy
Lab Director LE G. HUA

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