05D1038092 CLIA NUMBER - SAV ON PHARMACY #0108

Laboratory Demographics

  • CLIA Code: 05D1038092
  • Facility Name: SAV ON PHARMACY #0108
  • Facility Address: 1735 ARTESIA BLVD
    GARDENA, CA
    ZIP 90247
  • Facility Phone: 310 380-4650
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HILARRY BROASTER
  • NPI Number: 1871549386
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1038092
LAB Type Pharmacy
Facility Name SAV ON PHARMACY #0108
Street 1735 ARTESIA BLVD
City GARDENA
State CA
ZIP 90247
Phone 310 380-4650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Pharmacy
Lab Director HILARRY BROASTER

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