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

Laboratory Demographics

CLIA Number: 10D2284163

Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #3642

Facility Address:
7030 JOG RD
LAKE WORTH, FL
ZIP 33467
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Facility Phone Number: 561 967-3311

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558465476

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	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	561 967-3311
CertificateType	4
CertificateEffectiveDate	6/20/2023
CertificateExpirationDate	6/19/2025
FacilityType	Waiver

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