05D1052323 CLIA NUMBER - RALPHS PHARMACY # 054

Laboratory Demographics

  • CLIA Code: 05D1052323
  • Facility Name: RALPHS PHARMACY # 054
  • Facility Address: 101 OLD GROVE RD
    OCEANSIDE, CA
    ZIP 92057
  • Facility Phone: 760 754-1906
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH W. PATRIC
  • NPI Number: 1518982115
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1052323
LAB Type Pharmacy
Facility Name RALPHS PHARMACY # 054
Street 101 OLD GROVE RD
City OCEANSIDE
State CA
ZIP 92057
Phone 760 754-1906
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Pharmacy
Lab Director KENNETH W. PATRIC

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