10D2222576 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #16207

Laboratory Demographics

CLIA Number: 10D2222576

Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #16207

Facility Address:
4711 BAYOU BLVD
PENSACOLA, FL
ZIP 32503
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1497858146

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	10D2222576
LAB Type	Pharmacy
Facility Name	HOLIDAY CVS, LLC DBA CVS/PHARMACY #16207
Street	4711 BAYOU BLVD
City	PENSACOLA
State	FL
ZIP	32503
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	4/29/2023
CertificateExpirationDate	4/28/2025
FacilityType	Waiver

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