05D2057155 CLIA NUMBER - VONS PHARMACY #1625

Laboratory Demographics

  • CLIA Code: 05D2057155
  • Facility Name: VONS PHARMACY #1625
  • Facility Address: 1260 W REDONDO BEACH BLVD
    GARDENA, CA
    ZIP 90247
  • Facility Phone: 310 767-7940
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LANA DANG
  • NPI Number: 1801822689
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2057155
LAB Type Pharmacy
Facility Name VONS PHARMACY #1625
Street 1260 W REDONDO BEACH BLVD
City GARDENA
State CA
ZIP 90247
Phone 310 767-7940
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 LANA DANG

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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