10D2187064 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #8383

Laboratory Demographics

  • CLIA Code: 10D2187064
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #8383
  • Facility Address: 5151 BELLE TERRE PKWY
    PALM COAST, FL
    ZIP 32137
  • Facility Phone: 386 446-9449
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BERNARD MBALLESUBE
  • NPI Number: 1952405847
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2187064
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #8383
Street 5151 BELLE TERRE PKWY
City PALM COAST
State FL
ZIP 32137
Phone 386 446-9449
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Pharmacy
Lab Director BERNARD MBALLESUBE

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