05D2303021 CLIA NUMBER - WALGREENS #10336

Laboratory Demographics

  • CLIA Code: 05D2303021
  • Facility Name: WALGREENS #10336
  • Facility Address: 1538 E CHAMPMAN AVE
    ORANGE, CA
    ZIP 92866
  • Facility Phone: 714 288-1790
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELLEN HONG
  • NPI Number: 1154556710
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2303021
LAB Type Pharmacy
Facility Name WALGREENS #10336
Street 1538 E CHAMPMAN AVE
City ORANGE
State CA
ZIP 92866
Phone 714 288-1790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Pharmacy
Lab Director ELLEN HONG

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