05D2058085 CLIA NUMBER - VONS PHARMACY #2093

Laboratory Demographics

  • CLIA Code: 05D2058085
  • Facility Name: VONS PHARMACY #2093
  • Facility Address: 8011 UNIVERSITY AVE
    LA MESA, CA
    ZIP 91942
  • Facility Phone: 619 464-1102
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY HONRADA RPH
  • NPI Number: 1174569784
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2058085
LAB Type Pharmacy
Facility Name VONS PHARMACY #2093
Street 8011 UNIVERSITY AVE
City LA MESA
State CA
ZIP 91942
Phone 619 464-1102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2023
Certificate Expiration Date 4/28/2025
Facility Type Pharmacy
Lab Director TIMOTHY HONRADA RPH

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This page was last updated on: 3/20/2025