10D2259159 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #1293

Laboratory Demographics

  • CLIA Code: 10D2259159
  • Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #1293
  • Facility Address: 12804 US HWY 301
    DADE CITY, FL
    ZIP 33525
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICIA HOGABOAM
  • NPI Number: 1235233214
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2259159
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #1293
Street 12804 US HWY 301
City DADE CITY
State FL
ZIP 33525
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Pharmacy
Lab Director PATRICIA HOGABOAM

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