10D2221892 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #4440

Laboratory Demographics

  • CLIA Code: 10D2221892
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #4440
  • Facility Address: 434 RACETRACK RD NE
    FORT WALTON BEACH, FL
    ZIP 32547
  • Facility Phone: 850 315-0474
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA FLORES
  • NPI Number: 1194829044
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2221892
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #4440
Street 434 RACETRACK RD NE
City FORT WALTON BEACH
State FL
ZIP 32547
Phone 850 315-0474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director JESSICA FLORES

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