10D2227035 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #3673

Laboratory Demographics

  • CLIA Code: 10D2227035
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #3673
  • Facility Address: 2497 S WOODLAND BLVD
    DELAND, FL
    ZIP 32720
  • Facility Phone: 386 736-9001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PETER ADEOSUN
  • NPI Number: 1134223118
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2227035
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #3673
Street 2497 S WOODLAND BLVD
City DELAND
State FL
ZIP 32720
Phone 386 736-9001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Pharmacy
Lab Director PETER ADEOSUN

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