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05D1067936 CLIA NUMBER - VONS PHARMACY #2659

Laboratory Demographics

CLIA Number: 05D1067936

Facility Name: VONS PHARMACY #2659

Facility Address:
3520 RIVERSIDE PLAZA
RIVERSIDE, CA
ZIP 92506
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Facility Phone Number: 951 342-7930

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1851337620

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 05D1067936
LAB Type Pharmacy
Facility Name VONS PHARMACY #2659
Street 3520 RIVERSIDE PLAZA
City RIVERSIDE
State CA
ZIP 92506
Phone 951 342-7930
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