05D2065770 CLIA NUMBER - VONS PHARMACY # 3058

Laboratory Demographics

  • CLIA Code: 05D2065770
  • Facility Name: VONS PHARMACY # 3058
  • Facility Address: 57590 29 PALMS HWY
    YUCCA VALLEY, CA
    ZIP 92284
  • Facility Phone: 760 365-0651
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN GRIGGS
  • NPI Number: 1912933797
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2065770
LAB Type Pharmacy
Facility Name VONS PHARMACY # 3058
Street 57590 29 PALMS HWY
City YUCCA VALLEY
State CA
ZIP 92284
Phone 760 365-0651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Pharmacy
Lab Director JOHN GRIGGS

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