05D2307516 CLIA NUMBER - VERMONT V.O. PHARMACY

Laboratory Demographics

  • CLIA Code: 05D2307516
  • Facility Name: VERMONT V.O. PHARMACY
  • Facility Address: 2655 W OLYMPIC BLVD, STE 104
    LOS ANGELES, CA
    ZIP 90006
  • Facility Phone: 213 480-1503
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDWARD H. LEE
  • NPI Number: 1346236973
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307516
LAB Type Pharmacy
Facility Name VERMONT V.O. PHARMACY
Street 2655 W OLYMPIC BLVD, STE 104
City LOS ANGELES
State CA
ZIP 90006
Phone 213 480-1503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Pharmacy
Lab Director EDWARD H. LEE

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