05D0999682 CLIA NUMBER - RALPHS PHARMACY #686 MOBILE CLIA ,

Laboratory Demographics

  • CLIA Code: 05D0999682
  • Facility Name: RALPHS PHARMACY #686 MOBILE CLIA ,
  • Facility Address: 33145 TEMECULA PARKWAY
    TEMECULA, CA
    ZIP 92592
  • Facility Phone: 951 303-8764
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH W. PATRIC, MD
  • NPI Number: 1801811401
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D0999682
LAB Type Pharmacy
Facility Name RALPHS PHARMACY #686 MOBILE CLIA ,
Street 33145 TEMECULA PARKWAY
City TEMECULA
State CA
ZIP 92592
Phone 951 303-8764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2024
Certificate Expiration Date 5/19/2026
Facility Type Pharmacy
Lab Director KENNETH W. PATRIC, MD

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