05D2274793 CLIA NUMBER - CVS/PHARMACY #02881

Laboratory Demographics

  • CLIA Code: 05D2274793
  • Facility Name: CVS/PHARMACY #02881
  • Facility Address: 1120 FOREST AVE
    CHICO, CA
    ZIP 95928
  • Facility Phone: 530 894-5112
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THEODORE HOLCOMB
  • NPI Number: 1780951806
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2274793
LAB Type Pharmacy
Facility Name CVS/PHARMACY #02881
Street 1120 FOREST AVE
City CHICO
State CA
ZIP 95928
Phone 530 894-5112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Pharmacy
Lab Director THEODORE HOLCOMB

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