05D1011108 CLIA NUMBER - RALPHS PHARMACY #295 MOBILE CLIA

Laboratory Demographics

  • CLIA Code: 05D1011108
  • Facility Name: RALPHS PHARMACY #295 MOBILE CLIA
  • Facility Address: 8626 FIRESTONE BLVD
    DOWNEY, CA
    ZIP 90241
  • Facility Phone: 562 622-9238
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH W. PATRIC MD
  • NPI Number: 1174548770
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1011108
LAB Type Pharmacy
Facility Name RALPHS PHARMACY #295 MOBILE CLIA
Street 8626 FIRESTONE BLVD
City DOWNEY
State CA
ZIP 90241
Phone 562 622-9238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Pharmacy
Lab Director KENNETH W. PATRIC MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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