05D1067905 CLIA NUMBER - VONS PHARMACY #2079

Laboratory Demographics

  • CLIA Code: 05D1067905
  • Facility Name: VONS PHARMACY #2079
  • Facility Address: 11986 BERNARDO PLAZA
    RANCHO BERNARDO, CA
    ZIP 92128
  • Facility Phone: 858 485-1704
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DARREN A. FUJIMOTO
  • NPI Number: 1316983927
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1067905
LAB Type Pharmacy
Facility Name VONS PHARMACY #2079
Street 11986 BERNARDO PLAZA
City RANCHO BERNARDO
State CA
ZIP 92128
Phone 858 485-1704
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 DARREN A. FUJIMOTO

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