05D2271814 CLIA NUMBER - CVS/PHARMACY #09642

Laboratory Demographics

  • CLIA Code: 05D2271814
  • Facility Name: CVS/PHARMACY #09642
  • Facility Address: 8530 RESEDA BLVD
    NORTHRIDGE, CA
    ZIP 91324
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MISUN KIM
  • NPI Number: 1730125899
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2271814
LAB Type Pharmacy
Facility Name CVS/PHARMACY #09642
Street 8530 RESEDA BLVD
City NORTHRIDGE
State CA
ZIP 91324
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 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Pharmacy
Lab Director MISUN KIM

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