05D2058060 CLIA NUMBER - Pavilions Pharmacy 2212

Laboratory Demographics

CLIA Number: 05D2058060

Facility Name: Pavilions Pharmacy 2212

Facility Address:
11030 W Jefferson Blvd, Vons Pharmacy 2212
Culver City, CA
ZIP 90230
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Facility Phone Number: (310) 398-8044

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1538105176

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 05D2058060
LAB Type PHARMACY
Facility Name Pavilions Pharmacy 2212
Street 11030 W Jefferson Blvd, Vons Pharmacy 2212
City Culver City
State CA
ZIP 90230
Phone 3103988044

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This page was last updated on: 5/19/2019