05D2271390 CLIA NUMBER - CVS/PHARMACY #03117

Laboratory Demographics

  • CLIA Code: 05D2271390
  • Facility Name: CVS/PHARMACY #03117
  • Facility Address: 1651 BELLEVUE AVE
    ATWATER, CA
    ZIP 95301
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHWINDER TUNG
  • NPI Number: 1154507374
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2271390
LAB Type Pharmacy
Facility Name CVS/PHARMACY #03117
Street 1651 BELLEVUE AVE
City ATWATER
State CA
ZIP 95301
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 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Pharmacy
Lab Director JOSHWINDER TUNG

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