05D2307307 CLIA NUMBER - WALGREENS 10262

Laboratory Demographics

  • CLIA Code: 05D2307307
  • Facility Name: WALGREENS 10262
  • Facility Address: 9830 LONG BEACH BLVD
    SOUTH GATE, CA
    ZIP 90280
  • Facility Phone: 323 357-3925
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IRESHKA JAYASUNDERA
  • NPI Number: 1750450714
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307307
LAB Type Pharmacy
Facility Name WALGREENS 10262
Street 9830 LONG BEACH BLVD
City SOUTH GATE
State CA
ZIP 90280
Phone 323 357-3925
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Pharmacy
Lab Director IRESHKA JAYASUNDERA

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