05D2304507 CLIA NUMBER - WALGREENS 09817

Laboratory Demographics

  • CLIA Code: 05D2304507
  • Facility Name: WALGREENS 09817
  • Facility Address: 9305 MISSION GORGE RD
    SANTEE, CA
    ZIP 92071
  • Facility Phone: 619 258-8011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LE G. HUA
  • NPI Number: 1124262316
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2304507
LAB Type Pharmacy
Facility Name WALGREENS 09817
Street 9305 MISSION GORGE RD
City SANTEE
State CA
ZIP 92071
Phone 619 258-8011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Pharmacy
Lab Director LE G. HUA

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