05D2064908 CLIA NUMBER - VONS PHARMACY # 2306

Laboratory Demographics

  • CLIA Code: 05D2064908
  • Facility Name: VONS PHARMACY # 2306
  • Facility Address: 3900 BROAD ST.
    SAN LUIS OBISPO, CA
    ZIP 93401
  • Facility Phone: 805 541-1132
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM SPARKS
  • NPI Number: 1790714731
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2064908
LAB Type Pharmacy
Facility Name VONS PHARMACY # 2306
Street 3900 BROAD ST.
City SAN LUIS OBISPO
State CA
ZIP 93401
Phone 805 541-1132
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 WILLIAM SPARKS

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