05D2292176 CLIA NUMBER - CVS/PHARMACY #09689

Laboratory Demographics

CLIA Number: 05D2292176

Facility Name: CVS/PHARMACY #09689

Facility Address:
960 WEST FOOTHILL BLVD
MONROVIA, CA
ZIP 91016
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Facility Phone Number: 626 357-1818

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1669413571

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	05D2292176
LAB Type	Pharmacy
Facility Name	CVS/PHARMACY #09689
Street	960 WEST FOOTHILL BLVD
City	MONROVIA
State	CA
ZIP	91016
Phone	626 357-1818
CertificateType	4
CertificateEffectiveDate	10/20/2023
CertificateExpirationDate	10/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024