05D1067916 CLIA NUMBER - VONS PHARMACY #2107

Laboratory Demographics

  • CLIA Code: 05D1067916
  • Facility Name: VONS PHARMACY #2107
  • Facility Address: 10675 SCRIPPS POWAY PKWY
    SAN DIEGO, CA
    ZIP 92131
  • Facility Phone: 858 693-1545
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOJGAN EMDAD
  • NPI Number: 1073544888
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1067916
LAB Type Pharmacy
Facility Name VONS PHARMACY #2107
Street 10675 SCRIPPS POWAY PKWY
City SAN DIEGO
State CA
ZIP 92131
Phone 858 693-1545
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 MOJGAN EMDAD

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