05D2271489 CLIA NUMBER - CVS/PHARMACY #09644

Laboratory Demographics

  • CLIA Code: 05D2271489
  • Facility Name: CVS/PHARMACY #09644
  • Facility Address: 16975 BEAR VALLEY RD
    HESPERIA, CA
    ZIP 92345
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IJEOMA NWOKENNA
  • NPI Number: 1619912516
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2271489
LAB Type Pharmacy
Facility Name CVS/PHARMACY #09644
Street 16975 BEAR VALLEY RD
City HESPERIA
State CA
ZIP 92345
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 IJEOMA NWOKENNA

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