05D2215838 CLIA NUMBER - SOUTH BAY PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2215838
  • Facility Name: SOUTH BAY PHARMACY
  • Facility Address: 750 MEDICAL CENTER CT SUITE 8 UNIT A
    CHULA VISTA, CA
    ZIP 91911
  • Facility Phone: 619 373-9700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOLAGH HALA PIC
  • NPI Number: 1942659149
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2215838
LAB Type Pharmacy
Facility Name SOUTH BAY PHARMACY
Street 750 MEDICAL CENTER CT SUITE 8 UNIT A
City CHULA VISTA
State CA
ZIP 91911
Phone 619 373-9700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director JOLAGH HALA PIC

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