10D2187011 CLIA NUMBER - HOLIDAY CVS, LLC

Laboratory Demographics

CLIA Number: 10D2187011

Facility Name: HOLIDAY CVS, LLC

Facility Address:
13591 JETPORT COMMERCE PARKWAY
FORT MYERS, FL
ZIP 33913
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Facility Phone Number: (401) 770-6431

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1962424572

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	10D2187011
LAB Type	PHARMACY
Facility Name	HOLIDAY CVS, LLC
Street	13591 JETPORT COMMERCE PARKWAY
City	FORT MYERS
State	FL
ZIP	33913
Phone	(401) 770-6431

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This page was last updated on: 5/11/2023