05D2269153 CLIA NUMBER - GENCARE PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2269153
  • Facility Name: GENCARE PHARMACY
  • Facility Address: 15761 TUSTIN VILLAGE WAY SUITE 108
    TUSTIN, CA
    ZIP 92780
  • Facility Phone: 714 486-3455
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNY B. DANG
  • NPI Number: 1912529645
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2269153
LAB Type Pharmacy
Facility Name GENCARE PHARMACY
Street 15761 TUSTIN VILLAGE WAY SUITE 108
City TUSTIN
State CA
ZIP 92780
Phone 714 486-3455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Pharmacy
Lab Director JENNY B. DANG

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