05D1067914 CLIA NUMBER - VONS PHARMACY #2081

Laboratory Demographics

  • CLIA Code: 05D1067914
  • Facility Name: VONS PHARMACY #2081
  • Facility Address: 13255 BLACK MOUNTAIN RD
    SAN DIEGO, CA
    ZIP 92129
  • Facility Phone: 858 484-7241
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMANTHA T. NGUYEN
  • NPI Number: 1285670893
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1067914
LAB Type Pharmacy
Facility Name VONS PHARMACY #2081
Street 13255 BLACK MOUNTAIN RD
City SAN DIEGO
State CA
ZIP 92129
Phone 858 484-7241
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 SAMANTHA T. NGUYEN

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