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10D2222331 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #3927

Laboratory Demographics

CLIA Number: 10D2222331

Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #3927

Facility Address:
700 E LAKE RD
PALM HARBOR, FL
ZIP 34685
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1952323578

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 10D2222331
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #3927
Street 700 E LAKE RD
City PALM HARBOR
State FL
ZIP 34685
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 4/28/2023
CertificateExpirationDate 4/27/2025
FacilityType Waiver

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