10D2223168 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #3657

Laboratory Demographics

  • CLIA Code: 10D2223168
  • Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #3657
  • Facility Address: 1250 PROVIDENCE BLVD
    DELTONA, FL
    ZIP 32725
  • Facility Phone: 386 574-5291
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TARINA PATEL
  • NPI Number: 1720182637
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2223168
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #3657
Street 1250 PROVIDENCE BLVD
City DELTONA
State FL
ZIP 32725
Phone 386 574-5291
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 TARINA PATEL

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