05D2065801 CLIA NUMBER - VONS PHARMACY #2175

Laboratory Demographics

  • CLIA Code: 05D2065801
  • Facility Name: VONS PHARMACY #2175
  • Facility Address: 78271 HIGHWAY 111
    LA QUINTA, CA
    ZIP 92253
  • Facility Phone: 760 564-2225
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH STEIN
  • NPI Number: 1336178375
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2065801
LAB Type Pharmacy
Facility Name VONS PHARMACY #2175
Street 78271 HIGHWAY 111
City LA QUINTA
State CA
ZIP 92253
Phone 760 564-2225
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 KENNETH STEIN

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