10D2284163 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #3642

Laboratory Demographics

  • CLIA Code: 10D2284163
  • Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #3642
  • Facility Address: 7030 JOG RD
    LAKE WORTH, FL
    ZIP 33467
  • Facility Phone: (561) 967-3311
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA KHATER
  • NPI Number: 1558465476
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2284163
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #3642
Street 7030 JOG RD
City LAKE WORTH
State FL
ZIP 33467
Phone 5619673311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2025
Certificate Expiration Date 6/19/2027
Facility Type Pharmacy
Lab Director AMANDA KHATER

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This page was last updated on: 5/18/2026