07D2224885 CLIA NUMBER - CONNECTICUT CVS PHARMACY, LLC DBA- CVS PHARMACY # 02475

Laboratory Demographics

CLIA Number: 07D2224885

Facility Name: CONNECTICUT CVS PHARMACY, LLC DBA- CVS PHARMACY # 02475

Facility Address:
122 EAST PUTNAM AVE
COS COB, CT
ZIP 06807
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1649429952

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	07D2224885
LAB Type	Pharmacy
Facility Name	CONNECTICUT CVS PHARMACY, LLC DBA- CVS PHARMACY # 02475
Street	122 EAST PUTNAM AVE
City	COS COB
State	CT
ZIP	06807
Phone	866 389-2727
CertificateType	4
CertificateEffectiveDate	5/17/2023
CertificateExpirationDate	5/16/2025
FacilityType	Waiver

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