05D2316599 CLIA NUMBER - FORTUNA PHARMACY INC

Laboratory Demographics

  • CLIA Code: 05D2316599
  • Facility Name: FORTUNA PHARMACY INC
  • Facility Address: 1058 MAIN ST
    FORTUNA, CA
    ZIP 95540
  • Facility Phone: 707 725-3040
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN J. BURGESS
  • NPI Number: 1881806610
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2316599
LAB Type Pharmacy
Facility Name FORTUNA PHARMACY INC
Street 1058 MAIN ST
City FORTUNA
State CA
ZIP 95540
Phone 707 725-3040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type Pharmacy
Lab Director SUSAN J. BURGESS

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