10D2284261 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS PHARMACY #652

Laboratory Demographics

  • CLIA Code: 10D2284261
  • Facility Name: HOLIDAY CVS LLC DBA CVS PHARMACY #652
  • Facility Address: 57 TUSCAN WAY
    SAINT AUGUSTINE, FL
    ZIP 32092
  • Facility Phone: 904 940-3817
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN DEVLIN
  • NPI Number: 1295912079
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2284261
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS PHARMACY #652
Street 57 TUSCAN WAY
City SAINT AUGUSTINE
State FL
ZIP 32092
Phone 904 940-3817
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Pharmacy
Lab Director JOHN DEVLIN

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