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10D2187125 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #587

Laboratory Demographics

CLIA Number: 10D2187125

Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #587

Facility Address:
120 W VAN FLEET DR
BARTOW, FL
ZIP 33830
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1336243310

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 10D2187125
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #587
Street 120 W VAN FLEET DR
City BARTOW
State FL
ZIP 33830
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 6/25/2022
CertificateExpirationDate 6/24/2024
FacilityType Waiver

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