05D2290497 CLIA NUMBER - CVS/PHARMACY #09846

Laboratory Demographics

CLIA Number: 05D2290497

Facility Name: CVS/PHARMACY #09846

Facility Address:
6800 N MILBURN
FRESNO, CA
ZIP 93722
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Facility Phone Number: 559 451-3486

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1477732014

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	05D2290497
LAB Type	Pharmacy
Facility Name	CVS/PHARMACY #09846
Street	6800 N MILBURN
City	FRESNO
State	CA
ZIP	93722
Phone	559 451-3486
CertificateType	4
CertificateEffectiveDate	9/26/2023
CertificateExpirationDate	9/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024