05D2056226 CLIA NUMBER - VONS PHARMACY # 2409

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Laboratory Demographics

CLIA Number: 05D2056226

Facility Name: VONS PHARMACY # 2409

Facility Address:
40044 HIGHWAY 49 SUITE D
OAKHURST, CA
ZIP 93644
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Facility Phone Number: 559 642-4255

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1265478804

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	05D2056226
LAB Type	Pharmacy
Facility Name	VONS PHARMACY # 2409
Street	40044 HIGHWAY 49 SUITE D
City	OAKHURST
State	CA
ZIP	93644
Phone	559 642-4255
CertificateType	4
CertificateEffectiveDate	4/28/2024
CertificateExpirationDate	4/27/2026
FacilityType	Waiver

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