10D2259506 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #5178

Laboratory Demographics

  • CLIA Code: 10D2259506
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #5178
  • Facility Address: 1096 JOHNS SIMS PARKWAY
    NICEVILLE, FL
    ZIP 32578
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNA PACE
  • NPI Number: 1568566438
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2259506
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #5178
Street 1096 JOHNS SIMS PARKWAY
City NICEVILLE
State FL
ZIP 32578
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 5/6/2024
Certificate Expiration Date 5/5/2026
Facility Type Pharmacy
Lab Director JENNA PACE

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