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10D2187077 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #1261

Laboratory Demographics

CLIA Number: 10D2187077

Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #1261

Facility Address:
1510 SEMORAN BOULEVARD
WINTER PARK, FL
ZIP 32792
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1407878002

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 10D2187077
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #1261
Street 1510 SEMORAN BOULEVARD
City WINTER PARK
State FL
ZIP 32792
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 6/24/2022
CertificateExpirationDate 6/23/2024
FacilityType Waiver

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