05D2065503 CLIA NUMBER - VONS PHARMACY #1897

Laboratory Demographics

  • CLIA Code: 05D2065503
  • Facility Name: VONS PHARMACY #1897
  • Facility Address: 9643 MISSION GORGE RD
    SANTEE, CA
    ZIP 92071
  • Facility Phone: 619 596-5977
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRIET VO
  • NPI Number: 1023047057
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2065503
LAB Type Pharmacy
Facility Name VONS PHARMACY #1897
Street 9643 MISSION GORGE RD
City SANTEE
State CA
ZIP 92071
Phone 619 596-5977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Pharmacy
Lab Director TRIET VO

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