05D2056209 CLIA NUMBER - VONS PHARMACY #2665

Laboratory Demographics

  • CLIA Code: 05D2056209
  • Facility Name: VONS PHARMACY #2665
  • Facility Address: 4520 SUNSET BLVD.
    LOS ANGELES, CA
    ZIP 90027
  • Facility Phone: 323 662-2121
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE PHAM RPH
  • NPI Number: 1275579880
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2056209
LAB Type Pharmacy
Facility Name VONS PHARMACY #2665
Street 4520 SUNSET BLVD.
City LOS ANGELES
State CA
ZIP 90027
Phone 323 662-2121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director STEPHANIE PHAM RPH

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This page was last updated on: 3/20/2025