05D2064904 CLIA NUMBER - VONS PHARMACY # 1734

Laboratory Demographics

  • CLIA Code: 05D2064904
  • Facility Name: VONS PHARMACY # 1734
  • Facility Address: 522 N. ORANGE ST.
    REDLANDS, CA
    ZIP 92374
  • Facility Phone: 909 748-7788
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT ALLEN
  • NPI Number: 1821034430
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2064904
LAB Type Pharmacy
Facility Name VONS PHARMACY # 1734
Street 522 N. ORANGE ST.
City REDLANDS
State CA
ZIP 92374
Phone 909 748-7788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Pharmacy
Lab Director ROBERT ALLEN

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