CLIA lab
CLIA 05D1067896: Vons Pharmacy #1621
Nipomo, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1067896 belongs to Vons Pharmacy #1621 in Nipomo, CA.
Certificate of Waiver, effective April 27, 2025, expires April 26, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- April 27, 2025
- Certificate expiration
- April 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 27, 2007
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1067896
- Lab name
- Vons Pharmacy #1621
- Address
- 520 W Tefft St, Nipomo, CA 93444
- Phone
- (805) 931-1860
- Fax
- (805) 931-1866
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Nipomo, CA
- Community HealthCertificate of Accreditation, Independent05D2178991
- Community Health CentersCertificate of Waiver, Federally qualified health center05D0587259
- Garfield Beach CVS, LLCCertificate of Waiver, Pharmacy05D2229961
- Monarch Village Health CenterCertificate of Waiver, Community clinic05D2230214
- Nipomo Health CenterCertificate of Waiver, Community clinic05D2107198
Related
Questions
What is the CLIA number for Vons Pharmacy #1621 in Nipomo?
05D1067896, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Vons Pharmacy #1621 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1067896 expire?
The CMS file lists April 26, 2027 as the certificate expiration date; the certificate took effect April 27, 2025.