05D1067902 CLIA NUMBER - VONS PHARMACY #2053

Laboratory Demographics

  • CLIA Code: 05D1067902
  • Facility Name: VONS PHARMACY #2053
  • Facility Address: 3645 MIDWAY DRIVE
    SAN DIEGO, CA
    ZIP 92110
  • Facility Phone: 619 222-9736
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTHONY W. SINCONIS RPH
  • NPI Number: 1154350106
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1067902
LAB Type Pharmacy
Facility Name VONS PHARMACY #2053
Street 3645 MIDWAY DRIVE
City SAN DIEGO
State CA
ZIP 92110
Phone 619 222-9736
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 ANTHONY W. SINCONIS RPH

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