10D2226007 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #3552

Laboratory Demographics

  • CLIA Code: 10D2226007
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #3552
  • Facility Address: 27841 CROWN LAKE BLVD, PO 2327
    BONITA SPRINGS, FL
    ZIP 34135
  • Facility Phone: 239 992-2130
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTHA MICHAEL
  • NPI Number: 1922102847
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2226007
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #3552
Street 27841 CROWN LAKE BLVD, PO 2327
City BONITA SPRINGS
State FL
ZIP 34135
Phone 239 992-2130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director MARTHA MICHAEL

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