05D2315905 CLIA NUMBER - WALGREENS 03936

Laboratory Demographics

  • CLIA Code: 05D2315905
  • Facility Name: WALGREENS 03936
  • Facility Address: 24382 MUIRLANDS BLVD
    LAKE FOREST, CA
    ZIP 92630
  • Facility Phone: 949 598-9088
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANG NGUYEN
  • NPI Number: 1205841590
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2315905
LAB Type Pharmacy
Facility Name WALGREENS 03936
Street 24382 MUIRLANDS BLVD
City LAKE FOREST
State CA
ZIP 92630
Phone 949 598-9088
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Pharmacy
Lab Director DANG NGUYEN

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