05D2057151 CLIA NUMBER - VONS PHARMACY #1610

Laboratory Demographics

  • CLIA Code: 05D2057151
  • Facility Name: VONS PHARMACY #1610
  • Facility Address: 1790 N MOORPARK RD PHARMACY STORE #1610
    THOUSAND OAKS, CA
    ZIP 91360
  • Facility Phone: 805 497-8423
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RASHEL BANDARIZADEH
  • NPI Number: 1114956141
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2057151
LAB Type Pharmacy
Facility Name VONS PHARMACY #1610
Street 1790 N MOORPARK RD PHARMACY STORE #1610
City THOUSAND OAKS
State CA
ZIP 91360
Phone 805 497-8423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Pharmacy
Lab Director RASHEL BANDARIZADEH

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