10D2259259 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #4465

Laboratory Demographics

  • CLIA Code: 10D2259259
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #4465
  • Facility Address: 550 W BURLEIGH BLVD
    TAVARES, FL
    ZIP 32778
  • Facility Phone: 352 343-1502
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALLEN MICHAELS
  • NPI Number: 1912001868
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2259259
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #4465
Street 550 W BURLEIGH BLVD
City TAVARES
State FL
ZIP 32778
Phone 352 343-1502
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Pharmacy
Lab Director ALLEN MICHAELS

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