05D2065789 CLIA NUMBER - VONS PHARMACY # 2596

Laboratory Demographics

  • CLIA Code: 05D2065789
  • Facility Name: VONS PHARMACY # 2596
  • Facility Address: 369 MAGNOLIA AVENUE
    CORONA, CA
    ZIP 92879
  • Facility Phone: 951 549-1910
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA A. WOO
  • NPI Number: 1649201450
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2065789
LAB Type Pharmacy
Facility Name VONS PHARMACY # 2596
Street 369 MAGNOLIA AVENUE
City CORONA
State CA
ZIP 92879
Phone 951 549-1910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Pharmacy
Lab Director LISA A. WOO

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