05D2060268 CLIA NUMBER - PAVILIONS PHARMACY #2210

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Laboratory Demographics

CLIA Number: 05D2060268

Facility Name: PAVILIONS PHARMACY #2210

Facility Address:
26022 MARGUERITE PKWY
MISSION VIEJO, CA
ZIP 92692
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Facility Phone Number: 949 582-3294

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1972532927

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	05D2060268
LAB Type	Pharmacy
Facility Name	PAVILIONS PHARMACY #2210
Street	26022 MARGUERITE PKWY
City	MISSION VIEJO
State	CA
ZIP	92692
Phone	949 582-3294
CertificateType	4
CertificateEffectiveDate	6/10/2023
CertificateExpirationDate	6/9/2025
FacilityType	Waiver

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