10D2227430 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #4799

Laboratory Demographics

  • CLIA Code: 10D2227430
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #4799
  • Facility Address: 2105 13TH ST
    SAINT CLOUD, FL
    ZIP 34769
  • Facility Phone: 407 892-3213
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SOLANGEL CORDOVA
  • NPI Number: 1750485660
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2227430
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #4799
Street 2105 13TH ST
City SAINT CLOUD
State FL
ZIP 34769
Phone 407 892-3213
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 SOLANGEL CORDOVA

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