05D2269065 CLIA NUMBER - CVS/PHARMACY #09299

Laboratory Demographics

  • CLIA Code: 05D2269065
  • Facility Name: CVS/PHARMACY #09299
  • Facility Address: 1617 CANYON DRIVE
    PINOLE, CA
    ZIP 94564
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MALENA DE SANTOS
  • NPI Number: 1184647489
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2269065
LAB Type Pharmacy
Facility Name CVS/PHARMACY #09299
Street 1617 CANYON DRIVE
City PINOLE
State CA
ZIP 94564
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 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Pharmacy
Lab Director MALENA DE SANTOS

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