10D2222152 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS PHARMACY #3675

Laboratory Demographics

  • CLIA Code: 10D2222152
  • Facility Name: HOLIDAY CVS LLC DBA CVS PHARMACY #3675
  • Facility Address: 1 E NINE MILE RD
    PENSACOLA, FL
    ZIP 32534
  • Facility Phone: 850 475-1000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL ISSERMAN
  • NPI Number: 1831293752
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2222152
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS PHARMACY #3675
Street 1 E NINE MILE RD
City PENSACOLA
State FL
ZIP 32534
Phone 850 475-1000
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 MICHAEL ISSERMAN

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