05D2303494 CLIA NUMBER - WALGREENS 09560

Laboratory Demographics

  • CLIA Code: 05D2303494
  • Facility Name: WALGREENS 09560
  • Facility Address: 2453 S AZUSA AVE
    WEST COVINA, CA
    ZIP 91792
  • Facility Phone: 626 964-3101
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSIE YU
  • NPI Number: 1265460828
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2303494
LAB Type Pharmacy
Facility Name WALGREENS 09560
Street 2453 S AZUSA AVE
City WEST COVINA
State CA
ZIP 91792
Phone 626 964-3101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Pharmacy
Lab Director SUSIE YU

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