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10D2284496 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #2760

Laboratory Demographics

CLIA Number: 10D2284496

Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #2760

Facility Address:
2911 E FOWLER AVE
TAMPA, FL
ZIP 33612
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Facility Phone Number: 813 975-1998

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1700980679

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 10D2284496
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #2760
Street 2911 E FOWLER AVE
City TAMPA
State FL
ZIP 33612
Phone 813 975-1998
CertificateType 4
CertificateEffectiveDate 6/23/2023
CertificateExpirationDate 6/22/2025
FacilityType Waiver

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