05D2271815 CLIA NUMBER - CVS/PHARMACY #08943

Laboratory Demographics

  • CLIA Code: 05D2271815
  • Facility Name: CVS/PHARMACY #08943
  • Facility Address: 102 S SANDERSON AVE
    SAN JACINTO, CA
    ZIP 92582
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HUYEN PHAM
  • NPI Number: 1598099939
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2271815
LAB Type Pharmacy
Facility Name CVS/PHARMACY #08943
Street 102 S SANDERSON AVE
City SAN JACINTO
State CA
ZIP 92582
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 HUYEN PHAM

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This page was last updated on: 3/20/2025