05D2064940 CLIA NUMBER - VONS PHARMACY # 2071

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Laboratory Demographics

CLIA Number: 05D2064940

Facility Name: VONS PHARMACY # 2071

Facility Address:
2250 OTAY LAKES RD
CHULA VISTA, CA
ZIP 91915
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Facility Phone Number: 619 656-3629

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1508802109

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

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
CertificateType	4
CertificateEffectiveDate	12/13/2022
CertificateExpirationDate	12/12/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024