10D2222104 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #5174

Laboratory Demographics

  • CLIA Code: 10D2222104
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #5174
  • Facility Address: 1150 NE 26TH ST
    WILTON MANORS, FL
    ZIP 33305
  • Facility Phone: 954 566-7474
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHI NGUYEN
  • NPI Number: 1750485611
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2222104
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #5174
Street 1150 NE 26TH ST
City WILTON MANORS
State FL
ZIP 33305
Phone 954 566-7474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director CHI NGUYEN

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