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05D0977276 CLIA NUMBER - RALPHS PHARMACY #292

Laboratory Demographics

CLIA Number: 05D0977276

Facility Name: RALPHS PHARMACY #292

Facility Address:
1644 CLOVERFIELD AVE
SANTA MONICA, CA
ZIP 90404
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Facility Phone Number: 310 582-3915

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1578588174

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 05D0977276
LAB Type Pharmacy
Facility Name RALPHS PHARMACY #292
Street 1644 CLOVERFIELD AVE
City SANTA MONICA
State CA
ZIP 90404
Phone 310 582-3915
CertificateType 4
CertificateEffectiveDate 8/23/2022
CertificateExpirationDate 8/22/2024
FacilityType Waiver

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