05D2288235 CLIA NUMBER - CALAVERAS PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2288235
  • Facility Name: CALAVERAS PHARMACY
  • Facility Address: 114 S PARK VICTORIA DRIVE
    MILPITAS, CA
    ZIP 95035
  • Facility Phone: 408 262-2056
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FONCHUN WANG
  • NPI Number: 1568907475
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2288235
LAB Type Pharmacy
Facility Name CALAVERAS PHARMACY
Street 114 S PARK VICTORIA DRIVE
City MILPITAS
State CA
ZIP 95035
Phone 408 262-2056
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 FONCHUN WANG

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