05D2064938 CLIA NUMBER - VONS PHARMACY #2092

Laboratory Demographics

  • CLIA Code: 05D2064938
  • Facility Name: VONS PHARMACY #2092
  • Facility Address: 2048 E AVENIDA DE LOS ARBOLES
    THOUSAND OAKS, CA
    ZIP 91362
  • Facility Phone: 805 492-3511
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFERY PROCTOR
  • NPI Number: 1700822582
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2064938
LAB Type Pharmacy
Facility Name VONS PHARMACY #2092
Street 2048 E AVENIDA DE LOS ARBOLES
City THOUSAND OAKS
State CA
ZIP 91362
Phone 805 492-3511
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 JEFFERY PROCTOR

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