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23D2219200 CLIA NUMBER - WOODWARD DETROIT CVS LLC DBA CVS/PHARMACY #16656

Laboratory Demographics

CLIA Number: 23D2219200

Facility Name: WOODWARD DETROIT CVS LLC DBA CVS/PHARMACY #16656

Facility Address:
1301 COOLIDGE HWY
TROY, MI
ZIP 48084
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1255353926

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 23D2219200
LAB Type Pharmacy
Facility Name WOODWARD DETROIT CVS LLC DBA CVS/PHARMACY #16656
Street 1301 COOLIDGE HWY
City TROY
State MI
ZIP 48084
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 4/2/2023
CertificateExpirationDate 4/1/2025
FacilityType Waiver

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