05D2291415 CLIA NUMBER - MARINA DEL REY PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2291415
  • Facility Name: MARINA DEL REY PHARMACY
  • Facility Address: 4558 ADMIRALTY WAY
    MARINA DEL REY, CA
    ZIP 90292
  • Facility Phone: 310 823-5311
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH A. HEFLEY
  • NPI Number: 1336254358
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2291415
LAB Type Pharmacy
Facility Name MARINA DEL REY PHARMACY
Street 4558 ADMIRALTY WAY
City MARINA DEL REY
State CA
ZIP 90292
Phone 310 823-5311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Pharmacy
Lab Director ELIZABETH A. HEFLEY

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