05D1067936 CLIA NUMBER - VONS PHARMACY #2659

Laboratory Demographics

  • CLIA Code: 05D1067936
  • Facility Name: VONS PHARMACY #2659
  • Facility Address: 3520 RIVERSIDE PLAZA
    RIVERSIDE, CA
    ZIP 92506
  • Facility Phone: 951 342-7930
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL THUNQUEST PIC
  • NPI Number: 1851337620
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1067936
LAB Type Pharmacy
Facility Name VONS PHARMACY #2659
Street 3520 RIVERSIDE PLAZA
City RIVERSIDE
State CA
ZIP 92506
Phone 951 342-7930
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 MICHAEL THUNQUEST PIC

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