05D2058084 CLIA NUMBER - VONS PHARMACY # 2250

Laboratory Demographics

  • CLIA Code: 05D2058084
  • Facility Name: VONS PHARMACY # 2250
  • Facility Address: 16830 SAN FERNANDO MISSION BLVD.
    GRANADA HILLS, CA
    ZIP 91344
  • Facility Phone: 818 861-5059
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRIS KIM
  • NPI Number: 1407892011
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2058084
LAB Type Pharmacy
Facility Name VONS PHARMACY # 2250
Street 16830 SAN FERNANDO MISSION BLVD.
City GRANADA HILLS
State CA
ZIP 91344
Phone 818 861-5059
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Pharmacy
Lab Director KRIS KIM

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: 6/4/2025