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05D0573387 CLIA NUMBER - KAISER FOUNDATION HOSPITAL FONTANA

Laboratory Demographics

CLIA Number: 05D0573387

Facility Name: KAISER FOUNDATION HOSPITAL FONTANA

Facility Address:
9961 SIERRA AVE
FONTANA, CA
ZIP 92335
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Facility Phone Number: 909 302-8075

Facility Type: Hospital

Certificate Type: Accreditation
NPI Number: 1962568238

Taxonomy: 3336C0004X - Pharmacy
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

CLIA Record

Field Name Field Value
CLIA Number 05D0573387
LAB Type Hospital
Facility Name KAISER FOUNDATION HOSPITAL FONTANA
Street 9961 SIERRA AVE
City FONTANA
State CA
ZIP 92335
Phone 909 302-8075
CertificateType 1
CertificateEffectiveDate 11/14/2022
CertificateExpirationDate 11/13/2024
FacilityType Accreditation

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This page was last updated on: 4/23/2024