10D2284661 CLIA NUMBER - HOLIDAY CVS, LLC DBA CVS/PHARMACY #6853

Laboratory Demographics

  • CLIA Code: 10D2284661
  • Facility Name: HOLIDAY CVS, LLC DBA CVS/PHARMACY #6853
  • Facility Address: 49581 US HWY 27
    DAVENPORT, FL
    ZIP 33897
  • Facility Phone: 863 420-7563
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA AYENSU
  • NPI Number: 1659673713
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2284661
LAB Type Pharmacy
Facility Name HOLIDAY CVS, LLC DBA CVS/PHARMACY #6853
Street 49581 US HWY 27
City DAVENPORT
State FL
ZIP 33897
Phone 863 420-7563
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 JOSHUA AYENSU

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