05D2266776 CLIA NUMBER - MAICO PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2266776
  • Facility Name: MAICO PHARMACY
  • Facility Address: 10161 BOLSA AVE STE 105B
    WESTMINSTER, CA
    ZIP 92683
  • Facility Phone: 714 531-7000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEX H. HOGAN
  • NPI Number: 1396070215
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2266776
LAB Type Pharmacy
Facility Name MAICO PHARMACY
Street 10161 BOLSA AVE STE 105B
City WESTMINSTER
State CA
ZIP 92683
Phone 714 531-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Pharmacy
Lab Director ALEX H. HOGAN

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