05D1038850 CLIA NUMBER - SAV ON PHARMACY #3859

Laboratory Demographics

  • CLIA Code: 05D1038850
  • Facility Name: SAV ON PHARMACY #3859
  • Facility Address: 200 EAST SPULVEDA BLVD
    CARSON, CA
    ZIP 90745
  • Facility Phone: 310 513-6800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVEN J. SHEPARD
  • NPI Number: 1972559995
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1038850
LAB Type Pharmacy
Facility Name SAV ON PHARMACY #3859
Street 200 EAST SPULVEDA BLVD
City CARSON
State CA
ZIP 90745
Phone 310 513-6800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director STEVEN J. SHEPARD

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