10D2283890 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS PHARMACY #4072

Laboratory Demographics

  • CLIA Code: 10D2283890
  • Facility Name: HOLIDAY CVS LLC DBA CVS PHARMACY #4072
  • Facility Address: 1525 W 49TH ST
    HIALEAH, FL
    ZIP 33012
  • Facility Phone: 305 557-1365
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAIBEL CARBALLO
  • NPI Number: 1851495766
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2283890
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS PHARMACY #4072
Street 1525 W 49TH ST
City HIALEAH
State FL
ZIP 33012
Phone 305 557-1365
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Pharmacy
Lab Director MAIBEL CARBALLO

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