05D2307140 CLIA NUMBER - WALGREENS 09139

Laboratory Demographics

  • CLIA Code: 05D2307140
  • Facility Name: WALGREENS 09139
  • Facility Address: 670 N LAKE AVE
    PASADENA, CA
    ZIP 91101
  • Facility Phone: 626 585-8926
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GEOFFREY M. NGO
  • NPI Number: 1548217045
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307140
LAB Type Pharmacy
Facility Name WALGREENS 09139
Street 670 N LAKE AVE
City PASADENA
State CA
ZIP 91101
Phone 626 585-8926
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Pharmacy
Lab Director GEOFFREY M. NGO

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