05D2268542 CLIA NUMBER - CVS/PHARMACY #08589

Laboratory Demographics

  • CLIA Code: 05D2268542
  • Facility Name: CVS/PHARMACY #08589
  • Facility Address: 15286 SUMMIT AVE
    FONTANA, CA
    ZIP 92336
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAGGABAO TESTADO LINDSAY
  • NPI Number: 1265577589
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2268542
LAB Type Pharmacy
Facility Name CVS/PHARMACY #08589
Street 15286 SUMMIT AVE
City FONTANA
State CA
ZIP 92336
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Pharmacy
Lab Director PAGGABAO TESTADO LINDSAY

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