05D2057152 CLIA NUMBER - VONS PHARMACY# 1623

Laboratory Demographics

  • CLIA Code: 05D2057152
  • Facility Name: VONS PHARMACY# 1623
  • Facility Address: 4001 INGLEWOOD AVE
    REDONDO BEACH, CA
    ZIP 90278
  • Facility Phone: 310 349-0863
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UYEN DANG
  • NPI Number: 1699711200
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2057152
LAB Type Pharmacy
Facility Name VONS PHARMACY# 1623
Street 4001 INGLEWOOD AVE
City REDONDO BEACH
State CA
ZIP 90278
Phone 310 349-0863
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 UYEN DANG

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