05D2122996 CLIA NUMBER - VINCENT LY PHARMACY INCORPORATION DBA 986 PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2122996
  • Facility Name: VINCENT LY PHARMACY INCORPORATION DBA 986 PHARMACY
  • Facility Address: 701 S ATLANTIC BLVD STE 168
    MONTEREY PARK, CA
    ZIP 91754
  • Facility Phone: 626 782-7800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VINCENT T. LY, PIC
  • NPI Number: 1831781145
  • Taxonomy: 183500000X - Pharmacist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2122996
LAB Type Pharmacy
Facility Name VINCENT LY PHARMACY INCORPORATION DBA 986 PHARMACY
Street 701 S ATLANTIC BLVD STE 168
City MONTEREY PARK
State CA
ZIP 91754
Phone 626 782-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Pharmacy
Lab Director VINCENT T. LY, PIC

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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