05D2056225 CLIA NUMBER - VONS PHARMACY #2406

Laboratory Demographics

  • CLIA Code: 05D2056225
  • Facility Name: VONS PHARMACY #2406
  • Facility Address: 750 N IMPERIAL AVE
    EL CENTRO, CA
    ZIP 92243
  • Facility Phone: 760 353-2720
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FAWN L. WHITE
  • NPI Number: 1497784441
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2056225
LAB Type Pharmacy
Facility Name VONS PHARMACY #2406
Street 750 N IMPERIAL AVE
City EL CENTRO
State CA
ZIP 92243
Phone 760 353-2720
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 FAWN L. WHITE

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