05D2307362 CLIA NUMBER - WALGREENS 12332

Laboratory Demographics

  • CLIA Code: 05D2307362
  • Facility Name: WALGREENS 12332
  • Facility Address: 21650 US HIGHWAY 18
    APPLE VALLEY, CA
    ZIP 92307
  • Facility Phone: 760 240-0866
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW V. TRAN
  • NPI Number: 1679702179
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307362
LAB Type Pharmacy
Facility Name WALGREENS 12332
Street 21650 US HIGHWAY 18
City APPLE VALLEY
State CA
ZIP 92307
Phone 760 240-0866
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Pharmacy
Lab Director ANDREW V. TRAN

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