05D2275535 CLIA NUMBER - SAN JOSE PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2275535
  • Facility Name: SAN JOSE PHARMACY
  • Facility Address: 222 W EULALIST ST STE 212
    GLENDALE, CA
    ZIP 91204
  • Facility Phone: 818 247-3266
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEONGHO SO
  • NPI Number: 1902056732
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2275535
LAB Type Pharmacy
Facility Name SAN JOSE PHARMACY
Street 222 W EULALIST ST STE 212
City GLENDALE
State CA
ZIP 91204
Phone 818 247-3266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Pharmacy
Lab Director JEONGHO SO

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