05D1027397 CLIA NUMBER - RALPHS PHARMACY #729

Laboratory Demographics

  • CLIA Code: 05D1027397
  • Facility Name: RALPHS PHARMACY #729
  • Facility Address: 583 N VENTU PARK RD
    NEWBURY PARK, CA
    ZIP 91320
  • Facility Phone: 805 376-1380
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH W. PATRIC
  • NPI Number: 1528083128
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1027397
LAB Type Pharmacy
Facility Name RALPHS PHARMACY #729
Street 583 N VENTU PARK RD
City NEWBURY PARK
State CA
ZIP 91320
Phone 805 376-1380
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Pharmacy
Lab Director KENNETH W. PATRIC

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