05D2288227 CLIA NUMBER - GRACE COMMUNITY PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2288227
  • Facility Name: GRACE COMMUNITY PHARMACY
  • Facility Address: 4881 LA PALMA AVE
    LA PALMA, CA
    ZIP 90623
  • Facility Phone: 562 860-0586
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WOO SUNG AHN
  • NPI Number: 1801047964
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2288227
LAB Type Pharmacy
Facility Name GRACE COMMUNITY PHARMACY
Street 4881 LA PALMA AVE
City LA PALMA
State CA
ZIP 90623
Phone 562 860-0586
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Pharmacy
Lab Director WOO SUNG AHN

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