10D2223157 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #3289

Laboratory Demographics

  • CLIA Code: 10D2223157
  • Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #3289
  • Facility Address: 1255 NE JENSEN BEACH BLVD
    JENSEN BEACH, FL
    ZIP 34957
  • Facility Phone: 772 334-4204
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LILLY OLAVARRIA
  • NPI Number: 1336243294
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2223157
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #3289
Street 1255 NE JENSEN BEACH BLVD
City JENSEN BEACH
State FL
ZIP 34957
Phone 772 334-4204
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 LILLY OLAVARRIA

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