05D2016990 CLIA NUMBER - WESTERN UNIVERSITY OF HEALTH SCIENCES, DBA WESTERN UNIVERSITY PHARMACY

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Laboratory Demographics

CLIA Number: 05D2016990

Facility Name: WESTERN UNIVERSITY OF HEALTH SCIENCES, DBA WESTERN UNIVERSITY PHARMACY

Facility Address:
795 E SECOND ST STE 1
POMONA, CA
ZIP 91766
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Facility Phone Number: 909 706-3730

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1295051779

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	05D2016990
LAB Type	Pharmacy
Facility Name	WESTERN UNIVERSITY OF HEALTH SCIENCES, DBA WESTERN UNIVERSITY PHARMACY
Street	795 E SECOND ST STE 1
City	POMONA
State	CA
ZIP	91766
Phone	909 706-3730
CertificateType	4
CertificateEffectiveDate	12/1/2022
CertificateExpirationDate	11/30/2024
FacilityType	Waiver

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