05D2279190 CLIA NUMBER - LARK REXALL DRUGS, INC.

Laboratory Demographics

  • CLIA Code: 05D2279190
  • Facility Name: LARK REXALL DRUGS, INC.
  • Facility Address: 16251 MAIN STREET
    GUERNEVILLE, CA
    ZIP 95446
  • Facility Phone: 707 869-9055
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GREGORY P. LEVY
  • NPI Number: 1750484820
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2279190
LAB Type Pharmacy
Facility Name LARK REXALL DRUGS, INC.
Street 16251 MAIN STREET
City GUERNEVILLE
State CA
ZIP 95446
Phone 707 869-9055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Pharmacy
Lab Director GREGORY P. LEVY

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