05D2268817 CLIA NUMBER - CVS/PHARMACY #09649

Laboratory Demographics

  • CLIA Code: 05D2268817
  • Facility Name: CVS/PHARMACY #09649
  • Facility Address: 33499 YUCAIPA BLVD
    YUCAIPA, CA
    ZIP 92399
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERNEST OKYERE-GYASI
  • NPI Number: 1396786208
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2268817
LAB Type Pharmacy
Facility Name CVS/PHARMACY #09649
Street 33499 YUCAIPA BLVD
City YUCAIPA
State CA
ZIP 92399
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 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Pharmacy
Lab Director ERNEST OKYERE-GYASI

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