05D2004450 CLIA NUMBER - RALPHS PHARMACY # 299 MOBILE CLIA

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Laboratory Demographics

CLIA Number: 05D2004450

Facility Name: RALPHS PHARMACY # 299 MOBILE CLIA

Facility Address:
6300 IRVINE BLVD
IRVINE, CA
ZIP 92620
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Facility Phone Number: 949 559-1739

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1225195571

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	05D2004450
LAB Type	Pharmacy
Facility Name	RALPHS PHARMACY # 299 MOBILE CLIA
Street	6300 IRVINE BLVD
City	IRVINE
State	CA
ZIP	92620
Phone	949 559-1739
CertificateType	4
CertificateEffectiveDate	3/4/2024
CertificateExpirationDate	3/3/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024