05D2216949 CLIA NUMBER - KOVACS-FREY PHARMACY

Laboratory Demographics

CLIA Number: 05D2216949

Facility Name: KOVACS-FREY PHARMACY

Facility Address:
2860 ARTESIA BLVD
REDONDO BEACH, CA
ZIP 90278
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Facility Phone Number: 310 371-7541

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1619047826

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	05D2216949
LAB Type	Pharmacy
Facility Name	KOVACS-FREY PHARMACY
Street	2860 ARTESIA BLVD
City	REDONDO BEACH
State	CA
ZIP	90278
Phone	310 371-7541
CertificateType	4
CertificateEffectiveDate	3/17/2023
CertificateExpirationDate	3/16/2025
FacilityType	Waiver

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