05D2064940 CLIA NUMBER - VONS PHARMACY # 2071

Laboratory Demographics

  • CLIA Code: 05D2064940
  • Facility Name: VONS PHARMACY # 2071
  • Facility Address: 2250 OTAY LAKES RD
    CHULA VISTA, CA
    ZIP 91915
  • Facility Phone: 619 656-3629
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIM HAHN
  • NPI Number: 1508802109
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2064940
LAB Type Pharmacy
Facility Name VONS PHARMACY # 2071
Street 2250 OTAY LAKES RD
City CHULA VISTA
State CA
ZIP 91915
Phone 619 656-3629
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2024
Certificate Expiration Date 12/12/2026
Facility Type Pharmacy
Lab Director JIM HAHN

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