10D2284605 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVSPHARMACY #3624

Laboratory Demographics

  • CLIA Code: 10D2284605
  • Facility Name: HOLIDAY CVS, LLC DBA CVSPHARMACY #3624
  • Facility Address: 1208 W. JEFFERSON ST
    QUINCY, FL
    ZIP 32351
  • Facility Phone: 850 875-3021
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIEDRA ROBINSON
  • NPI Number: 1861596777
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2284605
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVSPHARMACY #3624
Street 1208 W. JEFFERSON ST
City QUINCY
State FL
ZIP 32351
Phone 850 875-3021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Pharmacy
Lab Director DIEDRA ROBINSON

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