05D2275141 CLIA NUMBER - CVS/PHARMACY #01520

Laboratory Demographics

  • CLIA Code: 05D2275141
  • Facility Name: CVS/PHARMACY #01520
  • Facility Address: 68-010 VISTA CHINO
    CATHEDRAL CITY, CA
    ZIP 92234
  • Facility Phone: 760 325-3229
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMAD SALAM
  • NPI Number: 1386688638
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2275141
LAB Type Pharmacy
Facility Name CVS/PHARMACY #01520
Street 68-010 VISTA CHINO
City CATHEDRAL CITY
State CA
ZIP 92234
Phone 760 325-3229
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Pharmacy
Lab Director AHMAD SALAM

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