05D2294093 CLIA NUMBER - GOLDEN ROSE PHARMACY INC

Laboratory Demographics

  • CLIA Code: 05D2294093
  • Facility Name: GOLDEN ROSE PHARMACY INC
  • Facility Address: 4070 BASELINE ROAD STE 110
    ROSEVILLE, CA
    ZIP 95747
  • Facility Phone: 916 572-1155
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FABRIA CLAPPER
  • NPI Number: 1174376370
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2294093
LAB Type Pharmacy
Facility Name GOLDEN ROSE PHARMACY INC
Street 4070 BASELINE ROAD STE 110
City ROSEVILLE
State CA
ZIP 95747
Phone 916 572-1155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Pharmacy
Lab Director FABRIA CLAPPER

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