07D2186003 CLIA NUMBER - CONNECTICUT CVS PHARMACY, LLC D/B/A- CVS PHARMACY # 364

Laboratory Demographics

  • CLIA Code: 07D2186003
  • Facility Name: CONNECTICUT CVS PHARMACY, LLC D/B/A- CVS PHARMACY # 364
  • Facility Address: 308 MAIN STREET EXT
    MIDDLETOWN, CT
    ZIP 06457
  • Facility Phone: 401 770-6431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANA MARIA GOMES
  • NPI Number: 1568820033
  • Taxonomy: 332BC3200X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 07D2186003
LAB Type Pharmacy
Facility Name CONNECTICUT CVS PHARMACY, LLC D/B/A- CVS PHARMACY # 364
Street 308 MAIN STREET EXT
City MIDDLETOWN
State CT
ZIP 06457
Phone 401 770-6431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2024
Certificate Expiration Date 6/11/2026
Facility Type Pharmacy
Lab Director ANA MARIA GOMES

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