05D2303191 CLIA NUMBER - WALGREENS 09588

Laboratory Demographics

  • CLIA Code: 05D2303191
  • Facility Name: WALGREENS 09588
  • Facility Address: 16145 SIERRA LAKES PKWY
    FONTANA, CA
    ZIP 92336
  • Facility Phone: 909 356-9167
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VANANH C. NGUYEN
  • NPI Number: 1609989177
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2303191
LAB Type Pharmacy
Facility Name WALGREENS 09588
Street 16145 SIERRA LAKES PKWY
City FONTANA
State CA
ZIP 92336
Phone 909 356-9167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Pharmacy
Lab Director VANANH C. NGUYEN

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