05D2302362 CLIA NUMBER - WALGREENS 09491

Laboratory Demographics

  • CLIA Code: 05D2302362
  • Facility Name: WALGREENS 09491
  • Facility Address: 10955 MAGNOLIA BLVD
    NORTH HOLLYWOOD, CA
    ZIP 91601
  • Facility Phone: 818 760-3820
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANI KANJ
  • NPI Number: 1386850873
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302362
LAB Type Pharmacy
Facility Name WALGREENS 09491
Street 10955 MAGNOLIA BLVD
City NORTH HOLLYWOOD
State CA
ZIP 91601
Phone 818 760-3820
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 AMANI KANJ

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