05D2202124 CLIA NUMBER - EXCEL SPECIALTY PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2202124
  • Facility Name: EXCEL SPECIALTY PHARMACY
  • Facility Address: 604 N MAGNOLIA AVE STE 105
    CLOVIS, CA
    ZIP 93611
  • Facility Phone: 559 375-1241
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDEMA ADEOLA
  • NPI Number: 1932769684
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2202124
LAB Type Physician Office
Facility Name EXCEL SPECIALTY PHARMACY
Street 604 N MAGNOLIA AVE STE 105
City CLOVIS
State CA
ZIP 93611
Phone 559 375-1241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Physician Office
Lab Director EDEMA ADEOLA

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