05D2207006 CLIA NUMBER - CLOVER PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2207006
  • Facility Name: CLOVER PHARMACY
  • Facility Address: 6170 THORNTON AVENUE SUITE E
    NEWARK, CA
    ZIP 94560
  • Facility Phone: 510 961-1288
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CONNIE MAN RPH
  • NPI Number: 1740812155
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2207006
LAB Type Pharmacy
Facility Name CLOVER PHARMACY
Street 6170 THORNTON AVENUE SUITE E
City NEWARK
State CA
ZIP 94560
Phone 510 961-1288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2024
Certificate Expiration Date 12/22/2026
Facility Type Pharmacy
Lab Director CONNIE MAN RPH

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