05D0977235 CLIA NUMBER - RALPHS PHARMACY #741 MOBILE CLIA

Laboratory Demographics

  • CLIA Code: 05D0977235
  • Facility Name: RALPHS PHARMACY #741 MOBILE CLIA
  • Facility Address: 674 LAS POSAS
    CAMARILLO, CA
    ZIP 93010
  • Facility Phone: 805 445-1431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH PATRIC
  • NPI Number: 1740205343
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D0977235
LAB Type Pharmacy
Facility Name RALPHS PHARMACY #741 MOBILE CLIA
Street 674 LAS POSAS
City CAMARILLO
State CA
ZIP 93010
Phone 805 445-1431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Pharmacy
Lab Director KENNETH PATRIC

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