05D2304309 CLIA NUMBER - WALGREENS 01870

Laboratory Demographics

  • CLIA Code: 05D2304309
  • Facility Name: WALGREENS 01870
  • Facility Address: 12109 APPLE VALLEY RD
    APPLE VALLEY, CA
    ZIP 92308
  • Facility Phone: 760 240-5896
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRISEYDA SEQUEIRA
  • NPI Number: 1871540948
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2304309
LAB Type Pharmacy
Facility Name WALGREENS 01870
Street 12109 APPLE VALLEY RD
City APPLE VALLEY
State CA
ZIP 92308
Phone 760 240-5896
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Pharmacy
Lab Director BRISEYDA SEQUEIRA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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