05D2111979 CLIA NUMBER - VONS PHARMACY #2386

Laboratory Demographics

  • CLIA Code: 05D2111979
  • Facility Name: VONS PHARMACY #2386
  • Facility Address: 27220 SUN CITY BLVD
    SUN CITY, CA
    ZIP 92586
  • Facility Phone: 951 679-8889
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN JEONG
  • NPI Number: 1417986464
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2111979
LAB Type Pharmacy
Facility Name VONS PHARMACY #2386
Street 27220 SUN CITY BLVD
City SUN CITY
State CA
ZIP 92586
Phone 951 679-8889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2024
Certificate Expiration Date 4/18/2026
Facility Type Pharmacy
Lab Director JOHN JEONG

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