05D2056776 CLIA NUMBER - VONS PHARMACY #2111

Laboratory Demographics

  • CLIA Code: 05D2056776
  • Facility Name: VONS PHARMACY #2111
  • Facility Address: 24160 LYONS AVE
    NEWHALL, CA
    ZIP 91321
  • Facility Phone: 661 259-9695
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TALIN D. MAZBANIAN
  • NPI Number: 1902835945
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2056776
LAB Type Pharmacy
Facility Name VONS PHARMACY #2111
Street 24160 LYONS AVE
City NEWHALL
State CA
ZIP 91321
Phone 661 259-9695
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Pharmacy
Lab Director TALIN D. MAZBANIAN

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