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

Laboratory Demographics

CLIA Number: 10D2259259

Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #4465

Facility Address:
550 W BURLEIGH BLVD
TAVARES, FL
ZIP 32778
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1912001868

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	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	866 389-2727
CertificateType	4
CertificateEffectiveDate	5/4/2024
CertificateExpirationDate	5/3/2026
FacilityType	Waiver

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