05D2302492 CLIA NUMBER - WALGREENS 09781

Laboratory Demographics

  • CLIA Code: 05D2302492
  • Facility Name: WALGREENS 09781
  • Facility Address: 82955 AVENUE 48
    INDIO, CA
    ZIP 92201
  • Facility Phone: 760 342-2031
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRYSTAL LESTARI
  • NPI Number: 1164693859
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302492
LAB Type Pharmacy
Facility Name WALGREENS 09781
Street 82955 AVENUE 48
City INDIO
State CA
ZIP 92201
Phone 760 342-2031
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Pharmacy
Lab Director CRYSTAL LESTARI

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