05D2138746 CLIA NUMBER - VENTURA COUNTY PHARMACY

Laboratory Demographics

CLIA Number: 05D2138746

Facility Name: VENTURA COUNTY PHARMACY

Facility Address:
3350 LOMA VISTA
VENTURA, CA
ZIP 93003
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Facility Phone Number: 805 765-6046

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1457417867

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2138746
LAB Type	Pharmacy
Facility Name	VENTURA COUNTY PHARMACY
Street	3350 LOMA VISTA
City	VENTURA
State	CA
ZIP	93003
Phone	805 765-6046
CertificateType	4
CertificateEffectiveDate	10/24/2023
CertificateExpirationDate	10/23/2025
FacilityType	Waiver

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