05D2076650 CLIA NUMBER - PLAZA PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2076650
  • Facility Name: PLAZA PHARMACY
  • Facility Address: 3400 W. LOMITA BLVD STE 102
    TORRANCE, CA
    ZIP 90505
  • Facility Phone: 310 530-3010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTIN C. KIM PIC
  • NPI Number: 1285625376
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2076650
LAB Type Pharmacy
Facility Name PLAZA PHARMACY
Street 3400 W. LOMITA BLVD STE 102
City TORRANCE
State CA
ZIP 90505
Phone 310 530-3010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Pharmacy
Lab Director MARTIN C. KIM PIC

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