05D2214039 CLIA NUMBER - ENCINO FAMILY PHARMACY

Laboratory Demographics

CLIA Number: 05D2214039

Facility Name: ENCINO FAMILY PHARMACY

Facility Address:
16060 VENTURA BLVD #109
ENCINO, CA
ZIP 91436
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Facility Phone Number: 818 387-8119

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1518215086

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	05D2214039
LAB Type	Pharmacy
Facility Name	ENCINO FAMILY PHARMACY
Street	16060 VENTURA BLVD #109
City	ENCINO
State	CA
ZIP	91436
Phone	818 387-8119
CertificateType	4
CertificateEffectiveDate	2/18/2023
CertificateExpirationDate	2/17/2025
FacilityType	Waiver

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