05D2279684 CLIA NUMBER - REDWOOD COMMUNITY PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2279684
  • Facility Name: REDWOOD COMMUNITY PHARMACY
  • Facility Address: 1567 CITY CENTER RD
    MCKINLEYVILLE, CA
    ZIP 95519
  • Facility Phone: 707 633-4884
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN OTTING
  • NPI Number: 1790436269
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2279684
LAB Type Pharmacy
Facility Name REDWOOD COMMUNITY PHARMACY
Street 1567 CITY CENTER RD
City MCKINLEYVILLE
State CA
ZIP 95519
Phone 707 633-4884
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director JUSTIN OTTING

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