05D2057157 CLIA NUMBER - VONS PHARMACY #2560

Laboratory Demographics

  • CLIA Code: 05D2057157
  • Facility Name: VONS PHARMACY #2560
  • Facility Address: 1758 W GRAND AVE
    GROVER BEACH, CA
    ZIP 93433
  • Facility Phone: 805 481-2492
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GREGORIO RODRIGUEZ JR
  • NPI Number: 1548299563
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2057157
LAB Type Pharmacy
Facility Name VONS PHARMACY #2560
Street 1758 W GRAND AVE
City GROVER BEACH
State CA
ZIP 93433
Phone 805 481-2492
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 GREGORIO RODRIGUEZ JR

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