05D2302505 CLIA NUMBER - WALGREENS 09105

Laboratory Demographics

  • CLIA Code: 05D2302505
  • Facility Name: WALGREENS 09105
  • Facility Address: 1280 W FOOTHILL BLVD
    RIALTO, CA
    ZIP 92376
  • Facility Phone: 909 879-0305
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NHA V. VO
  • NPI Number: 1184651788
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302505
LAB Type Pharmacy
Facility Name WALGREENS 09105
Street 1280 W FOOTHILL BLVD
City RIALTO
State CA
ZIP 92376
Phone 909 879-0305
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 NHA V. VO

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