05D2271488 CLIA NUMBER - CVS/PHARMACY #10931

Laboratory Demographics

  • CLIA Code: 05D2271488
  • Facility Name: CVS/PHARMACY #10931
  • Facility Address: 1745 S IMPERIAL AVE
    EL CENTRO, CA
    ZIP 92243
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAM GABBARA
  • NPI Number: 1366464968
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2271488
LAB Type Pharmacy
Facility Name CVS/PHARMACY #10931
Street 1745 S IMPERIAL AVE
City EL CENTRO
State CA
ZIP 92243
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 11/2/2024
Certificate Expiration Date 11/1/2026
Facility Type Pharmacy
Lab Director SAM GABBARA

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