10D2284532 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS/PHARMACY #3921

Laboratory Demographics

  • CLIA Code: 10D2284532
  • Facility Name: HOLIDAY CVS LLC DBA CVS/PHARMACY #3921
  • Facility Address: 12077 SOUTH ORANGE BLOSSOM TRAIL
    ORLANDO, FL
    ZIP 32837
  • Facility Phone: 407 240-2474
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARINA MANSOUR
  • NPI Number: 1376647222
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2284532
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS/PHARMACY #3921
Street 12077 SOUTH ORANGE BLOSSOM TRAIL
City ORLANDO
State FL
ZIP 32837
Phone 407 240-2474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Pharmacy
Lab Director MARINA MANSOUR

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