05D2065784 CLIA NUMBER - VONS PHARMACY # 2384

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Laboratory Demographics

CLIA Number: 05D2065784

Facility Name: VONS PHARMACY # 2384

Facility Address:
4733 E. PALM CANYON
PALM SPRINGS, CA
ZIP 92264
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Facility Phone Number: 760 324-8269

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1508895558

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	05D2065784
LAB Type	Pharmacy
Facility Name	VONS PHARMACY # 2384
Street	4733 E. PALM CANYON
City	PALM SPRINGS
State	CA
ZIP	92264
Phone	760 324-8269
CertificateType	4
CertificateEffectiveDate	8/4/2022
CertificateExpirationDate	8/3/2024
FacilityType	Waiver

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