10D2221959 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #5181

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Laboratory Demographics

CLIA Number: 10D2221959

Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #5181

Facility Address:
2303 SW 75TH ST
GAINESVILLE, FL
ZIP 32607
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1184728057

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	10D2221959
LAB Type	Pharmacy
Facility Name	HOLIDAY CVS LLC DBA CVS/PHARMACY #5181
Street	2303 SW 75TH ST
City	GAINESVILLE
State	FL
ZIP	32607
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	4/26/2023
CertificateExpirationDate	4/25/2025
FacilityType	Waiver

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