05D2187335 CLIA NUMBER - RIVER OAK PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2187335
  • Facility Name: RIVER OAK PHARMACY
  • Facility Address: 1080 W F STREET SUITE D
    OAKDALE, CA
    ZIP 95361
  • Facility Phone: 209 847-2226
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH W. COSNER
  • NPI Number: 1164433652
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2187335
LAB Type Pharmacy
Facility Name RIVER OAK PHARMACY
Street 1080 W F STREET SUITE D
City OAKDALE
State CA
ZIP 95361
Phone 209 847-2226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Pharmacy
Lab Director KENNETH W. COSNER

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