05D0977297 CLIA NUMBER - RALPHS PHARMACY #147 MOBILE CLIA

Laboratory Demographics

  • CLIA Code: 05D0977297
  • Facility Name: RALPHS PHARMACY #147 MOBILE CLIA
  • Facility Address: 27760 N MCBEAN PKWAY
    VALENCIA, CA
    ZIP 91355
  • Facility Phone: 661 263-6480
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH W. PATRIC MD
  • NPI Number: 1033134630
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D0977297
LAB Type Pharmacy
Facility Name RALPHS PHARMACY #147 MOBILE CLIA
Street 27760 N MCBEAN PKWAY
City VALENCIA
State CA
ZIP 91355
Phone 661 263-6480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Pharmacy
Lab Director KENNETH W. PATRIC MD

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