CLIA lab
CLIA 05D2230111: Walgreens# 12421
Poway, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2230111 belongs to Walgreens# 12421 in Poway, CA.
Certificate of Waiver, effective July 20, 2025, expires July 19, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 20, 2025
- Certificate expiration
- July 19, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 20, 2021
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D2230111
- Lab name
- Walgreens# 12421
- Address
- 13390 Poway Rd, Poway, CA 92064
- Phone
- (858) 435-7580
- Fax
- (858) 435-7586
Annual test volume the lab reported
- Waived tests
- 12,775
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Elizabeth Salada, MDCertificate of Waiver, Physician office05D1093341
- Ficare MedCertificate of Waiver, Physician office05D2029221
- Focus on Health Inc PowayCertificate for Provider-Performed Microscopy Procedures, Physician office05D2340294
- Kathy Clewell MDCertificate of Waiver, Community clinic05D0950023
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- Obstetrics & Gynecology Li Fan MD IncCertificate of Waiver, Physician office05D2120746
Related
Questions
What is the CLIA number for Walgreens# 12421 in Poway?
05D2230111, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walgreens# 12421 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2230111 expire?
The CMS file lists July 19, 2027 as the certificate expiration date; the certificate took effect July 20, 2025.