05D2065505 CLIA NUMBER - VONS PHARMACY #1742

Laboratory Demographics

  • CLIA Code: 05D2065505
  • Facility Name: VONS PHARMACY #1742
  • Facility Address: 7390 CHERRY AVE
    FONTANA, CA
    ZIP 92336
  • Facility Phone: 909 429-3933
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NAZMY B. GHATTAS
  • NPI Number: 1689603615
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2065505
LAB Type Pharmacy
Facility Name VONS PHARMACY #1742
Street 7390 CHERRY AVE
City FONTANA
State CA
ZIP 92336
Phone 909 429-3933
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 NAZMY B. GHATTAS

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