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10D2222680 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #16330

Laboratory Demographics

CLIA Number: 10D2222680

Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #16330

Facility Address:
4410 S HWY 17 92
CASSELBERRY, FL
ZIP 32707
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1073536371

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 10D2222680
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #16330
Street 4410 S HWY 17 92
City CASSELBERRY
State FL
ZIP 32707
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 4/30/2023
CertificateExpirationDate 4/29/2025
FacilityType Waiver

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