05D2321416 CLIA NUMBER - THE MEDICINE SHOPPE PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2321416
  • Facility Name: THE MEDICINE SHOPPE PHARMACY
  • Facility Address: 31946 MISSION TRAIL SUITE A-1
    LAKE ELSINORE, CA
    ZIP 92530
  • Facility Phone: 951 245-1371
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FADY MOSAAD
  • NPI Number: 1982169561
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2321416
LAB Type Pharmacy
Facility Name THE MEDICINE SHOPPE PHARMACY
Street 31946 MISSION TRAIL SUITE A-1
City LAKE ELSINORE
State CA
ZIP 92530
Phone 951 245-1371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Pharmacy
Lab Director FADY MOSAAD

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