CLIA lab
CLIA 05D1011110: Ralphs Pharmacy #21
South Pasadena, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1011110 belongs to Ralphs Pharmacy #21 in South Pasadena, CA.
Certificate of Waiver, effective April 1, 2025, expires March 31, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- April 1, 2025
- Certificate expiration
- March 31, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 1, 2003
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1011110
- Lab name
- Ralphs Pharmacy #21
- Address
- 1745 Garfield Ave, South Pasadena, CA 91030
- Phone
- (626) 799-2926
- Fax
- (626) 799-2183
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Moxie BirthCertificate for Provider-Performed Microscopy Procedures, Physician office05D2287714
- Pavillions Pharmacy # 2228Certificate of Waiver, Pharmacy05D2070908
- Radiant Wellness and Health PCCertificate of Waiver, Physician office05D2313063
- South Pasadena Care CenterCertificate of Waiver, Skilled nursing or nursing facility05D0918316
- South Pasadena Pediatrics,Certificate of Waiver, Physician office05D2324671
Related
Questions
What is the CLIA number for Ralphs Pharmacy #21 in South Pasadena?
05D1011110, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ralphs Pharmacy #21 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1011110 expire?
The CMS file lists March 31, 2027 as the certificate expiration date; the certificate took effect April 1, 2025.