05D2196046 CLIA NUMBER - OLYMPIC GERHART PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2196046
  • Facility Name: OLYMPIC GERHART PHARMACY
  • Facility Address: 5724 E OLYMPIC BLVD
    LOS ANGELES, CA
    ZIP 90022
  • Facility Phone: 323 722-1515
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAE C. SUH
  • NPI Number: 1689775306
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2196046
LAB Type Pharmacy
Facility Name OLYMPIC GERHART PHARMACY
Street 5724 E OLYMPIC BLVD
City LOS ANGELES
State CA
ZIP 90022
Phone 323 722-1515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Pharmacy
Lab Director JAE C. SUH

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