10D2223126 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #3151

Laboratory Demographics

  • CLIA Code: 10D2223126
  • Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #3151
  • Facility Address: 100 N MIRAMAR AVE
    INDIALANTIC, FL
    ZIP 32903
  • Facility Phone: 321 724-5634
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN GAGNON
  • NPI Number: 1689778565
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2223126
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #3151
Street 100 N MIRAMAR AVE
City INDIALANTIC
State FL
ZIP 32903
Phone 321 724-5634
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director JONATHAN GAGNON

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