05D2268624 CLIA NUMBER - RANCHO SPRINGS OUTPATIENT PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2268624
  • Facility Name: RANCHO SPRINGS OUTPATIENT PHARMACY
  • Facility Address: 25458 MEDICAL CENTER DR #110
    MURRIETA, CA
    ZIP 92562
  • Facility Phone: 951 698-4505
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL KIM
  • NPI Number: 1639496961
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2268624
LAB Type Pharmacy
Facility Name RANCHO SPRINGS OUTPATIENT PHARMACY
Street 25458 MEDICAL CENTER DR #110
City MURRIETA
State CA
ZIP 92562
Phone 951 698-4505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Pharmacy
Lab Director PAUL KIM

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