10D2227388 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #3650

Laboratory Demographics

  • CLIA Code: 10D2227388
  • Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #3650
  • Facility Address: 625 W DR MARTIN LUTHER KING JR BLVD
    TAMPA, FL
    ZIP 33603
  • Facility Phone: 813 232-2925
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAM NGUYEN
  • NPI Number: 1205933793
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2227388
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #3650
Street 625 W DR MARTIN LUTHER KING JR BLVD
City TAMPA
State FL
ZIP 33603
Phone 813 232-2925
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2025
Certificate Expiration Date 6/10/2027
Facility Type Pharmacy
Lab Director LAM NGUYEN

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This page was last updated on: 6/4/2025