50D2228899 CLIA NUMBER - CVS/PHARMACY #11023

Laboratory Demographics

  • CLIA Code: 50D2228899
  • Facility Name: CVS/PHARMACY #11023
  • Facility Address: 9400 GRAVELLY LAKE DR SW
    LAKEWOOD, WA
    ZIP 98499
  • Facility Phone: 253 584-1549
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHONA PIZAN
  • NPI Number: 1013939701
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2228899
LAB Type Pharmacy
Facility Name CVS/PHARMACY #11023
Street 9400 GRAVELLY LAKE DR SW
City LAKEWOOD
State WA
ZIP 98499
Phone 253 584-1549
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2021
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director CHONA PIZAN

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