05D1067901 CLIA NUMBER - VONS PHARMACY #2030

Laboratory Demographics

  • CLIA Code: 05D1067901
  • Facility Name: VONS PHARMACY #2030
  • Facility Address: 25850 NORTH THE OLD ROAD
    VALENCIA, CA
    ZIP 91355
  • Facility Phone: 661 254-5824
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VICTORIA A. JUKKA
  • NPI Number: 1679519441
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1067901
LAB Type Pharmacy
Facility Name VONS PHARMACY #2030
Street 25850 NORTH THE OLD ROAD
City VALENCIA
State CA
ZIP 91355
Phone 661 254-5824
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director VICTORIA A. JUKKA

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