05D2306825 CLIA NUMBER - RITE AID # 5696

Laboratory Demographics

  • CLIA Code: 05D2306825
  • Facility Name: RITE AID # 5696
  • Facility Address: 11673 CHERRY AVE
    FONTANA, CA
    ZIP 92337
  • Facility Phone: 909 357-2031
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MADHAVI CHITTEREDDY
  • NPI Number: 1346359882
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2306825
LAB Type Pharmacy
Facility Name RITE AID # 5696
Street 11673 CHERRY AVE
City FONTANA
State CA
ZIP 92337
Phone 909 357-2031
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Pharmacy
Lab Director MADHAVI CHITTEREDDY

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