05D2294603 CLIA NUMBER - CVS PHARMACY # 09728

Laboratory Demographics

  • CLIA Code: 05D2294603
  • Facility Name: CVS PHARMACY # 09728
  • Facility Address: 1322 W 6TH ST
    CORONA, CA
    ZIP 92882
  • Facility Phone: 951 817-8636
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHILLIP DO
  • NPI Number: 1760426019
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2294603
LAB Type Pharmacy
Facility Name CVS PHARMACY # 09728
Street 1322 W 6TH ST
City CORONA
State CA
ZIP 92882
Phone 951 817-8636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Pharmacy
Lab Director PHILLIP DO

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This page was last updated on: 6/4/2025