05D2308166 CLIA NUMBER - WALGREENS 10354

Laboratory Demographics

  • CLIA Code: 05D2308166
  • Facility Name: WALGREENS 10354
  • Facility Address: 2417 SYCAMORE DR
    SIMI VALLEY, CA
    ZIP 93065
  • Facility Phone: 805 526-3722
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BERNARD B. GOROSPE
  • NPI Number: 1790017622
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2308166
LAB Type Pharmacy
Facility Name WALGREENS 10354
Street 2417 SYCAMORE DR
City SIMI VALLEY
State CA
ZIP 93065
Phone 805 526-3722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Pharmacy
Lab Director BERNARD B. GOROSPE

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