05D1067921 CLIA NUMBER - VONS PHARMACY #2152

Laboratory Demographics

  • CLIA Code: 05D1067921
  • Facility Name: VONS PHARMACY #2152
  • Facility Address: 155 W CALIFORNIA RD
    PASADENA, CA
    ZIP 91105
  • Facility Phone: 626 577-2594
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NORAYR MINOSYAN
  • NPI Number: 1750310785
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1067921
LAB Type Pharmacy
Facility Name VONS PHARMACY #2152
Street 155 W CALIFORNIA RD
City PASADENA
State CA
ZIP 91105
Phone 626 577-2594
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 NORAYR MINOSYAN

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