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10D2227412 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #17275

Laboratory Demographics

CLIA Number: 10D2227412

Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #17275

Facility Address:
5601 NW 183RD ST
MIAMI GARDENS, FL
ZIP 33055
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1063698470

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 10D2227412
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #17275
Street 5601 NW 183RD ST
City MIAMI GARDENS
State FL
ZIP 33055
Phone 866 389-2727
CertificateType 4
CertificateEffectiveDate 6/11/2023
CertificateExpirationDate 6/10/2025
FacilityType Waiver

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