05D2271495 CLIA NUMBER - CVS/PHARMACY #03055

Laboratory Demographics

  • CLIA Code: 05D2271495
  • Facility Name: CVS/PHARMACY #03055
  • Facility Address: 38012 47TH ST E
    PALMDALE, CA
    ZIP 93552
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TROY THAMARATAYANOD
  • NPI Number: 1437429586
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2271495
LAB Type Pharmacy
Facility Name CVS/PHARMACY #03055
Street 38012 47TH ST E
City PALMDALE
State CA
ZIP 93552
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 TROY THAMARATAYANOD

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