05D1067929 CLIA NUMBER - VONS PHARMACY #2335

Laboratory Demographics

CLIA Number: 05D1067929

Facility Name: VONS PHARMACY #2335

Facility Address:
2684 N TUSTIN STREET
ORANGE, CA
ZIP 92865
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Facility Phone Number: 714 637-2140

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1518996552

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	05D1067929
LAB Type	Pharmacy
Facility Name	VONS PHARMACY #2335
Street	2684 N TUSTIN STREET
City	ORANGE
State	CA
ZIP	92865
Phone	714 637-2140
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024