10D2285384 CLIA NUMBER - HOLIDAY CVS LLC DBA CVS PHARMACY #5236

Laboratory Demographics

  • CLIA Code: 10D2285384
  • Facility Name: HOLIDAY CVS LLC DBA CVS PHARMACY #5236
  • Facility Address: 9170 DANIELS PKWY
    FORT MYERS, FL
    ZIP 33912
  • Facility Phone: 239 561-5151
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHELLETTA TILGHMAN
  • NPI Number: 1457455362
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2285384
LAB Type Pharmacy
Facility Name HOLIDAY CVS LLC DBA CVS PHARMACY #5236
Street 9170 DANIELS PKWY
City FORT MYERS
State FL
ZIP 33912
Phone 239 561-5151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Pharmacy
Lab Director SHELLETTA TILGHMAN

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