05D2057212 CLIA NUMBER - VONS PHARMACY # 1626

Laboratory Demographics

  • CLIA Code: 05D2057212
  • Facility Name: VONS PHARMACY # 1626
  • Facility Address: 3650 S BRISTOL ST
    SANTA ANA, CA
    ZIP 92704
  • Facility Phone: 714 540-0393
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRAM HOANG
  • NPI Number: 1083650626
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2057212
LAB Type Pharmacy
Facility Name VONS PHARMACY # 1626
Street 3650 S BRISTOL ST
City SANTA ANA
State CA
ZIP 92704
Phone 714 540-0393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Pharmacy
Lab Director TRAM HOANG

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