10D2225952 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #03437

Laboratory Demographics

CLIA Number: 10D2225952

Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #03437

Facility Address:
575 W INDIANTOWN RD
JUPITER, FL
ZIP 33458
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003910928

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	10D2225952
LAB Type	Pharmacy
Facility Name	HOLIDAY CVS LLC DBA CVS/PHARMACY #03437
Street	575 W INDIANTOWN RD
City	JUPITER
State	FL
ZIP	33458
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	5/25/2023
CertificateExpirationDate	5/24/2025
FacilityType	Waiver

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