25D2216602 CLIA NUMBER - MISSISSIPPI CVS PHARMACY LLC DBA CVS PHARMACY08310

Laboratory Demographics

  • CLIA Code: 25D2216602
  • Facility Name: MISSISSIPPI CVS PHARMACY LLC DBA CVS PHARMACY08310
  • Facility Address: 110 COLONY CROSSING
    MADISON, MS
    ZIP 39110
  • Facility Phone: 601 605-1348
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TYERRA DAY
  • NPI Number: 1760582100
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2216602
LAB Type Pharmacy
Facility Name MISSISSIPPI CVS PHARMACY LLC DBA CVS PHARMACY08310
Street 110 COLONY CROSSING
City MADISON
State MS
ZIP 39110
Phone 601 605-1348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director TYERRA DAY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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