05D2308172 CLIA NUMBER - WALGREENS 09616

Laboratory Demographics

  • CLIA Code: 05D2308172
  • Facility Name: WALGREENS 09616
  • Facility Address: 16020 PERRIS BLVD
    MORENO VALLEY, CA
    ZIP 92551
  • Facility Phone: 951 247-2113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MITHIL K. DALAL
  • NPI Number: 1528263308
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2308172
LAB Type Pharmacy
Facility Name WALGREENS 09616
Street 16020 PERRIS BLVD
City MORENO VALLEY
State CA
ZIP 92551
Phone 951 247-2113
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 MITHIL K. DALAL

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