07D2218611 CLIA NUMBER - CONNECTICUT CVS PHARMACY, LLC DBA- CVS PHARMACY # 01151

Laboratory Demographics

CLIA Number: 07D2218611

Facility Name: CONNECTICUT CVS PHARMACY, LLC DBA- CVS PHARMACY # 01151

Facility Address:
464 REIDVILLE DR
WATERBURY, CT
ZIP 06705
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1700352721

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D2218611
LAB Type	Pharmacy
Facility Name	CONNECTICUT CVS PHARMACY, LLC DBA- CVS PHARMACY # 01151
Street	464 REIDVILLE DR
City	WATERBURY
State	CT
ZIP	06705
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	3/30/2023
CertificateExpirationDate	3/29/2025
FacilityType	Waiver

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