05D2131597 CLIA NUMBER - REGENTS OF THE UNIVERSITY OF CALIFORNIA CLINICAL TRIALS CENTER/AIR

Laboratory Demographics

CLIA Number: 05D2131597

Facility Name: REGENTS OF THE UNIVERSITY OF CALIFORNIA CLINICAL TRIALS CENTER/AIR

Facility Address:
210 DICKINSON ST 1ST FLOOR
SAN DIEGO, CA
ZIP 92103
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Facility Phone Number: 619 471-0822

Facility Type: Other - CLINICAL RESEARCH

Certificate Type: Waiver

NPI Number: 1518300532

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	05D2131597
LAB Type	Other - CLINICAL RESEARCH
Facility Name	REGENTS OF THE UNIVERSITY OF CALIFORNIA CLINICAL TRIALS CENTER/AIR
Street	210 DICKINSON ST 1ST FLOOR
City	SAN DIEGO
State	CA
ZIP	92103
Phone	619 471-0822
CertificateType	4
CertificateEffectiveDate	6/1/2023
CertificateExpirationDate	5/31/2025
FacilityType	Waiver

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