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

Laboratory Demographics

CLIA Number: 25D2216602

Facility Name: MISSISSIPPI CVS PHARMACY LLC DBA CVS PHARMACY08310

Facility Address:
110 COLONY CROSSING
MADISON, MS
ZIP 39110
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Facility Phone Number: 601 605-1348

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1760582100

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 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
CertificateType 4
CertificateEffectiveDate 3/15/2023
CertificateExpirationDate 3/14/2025
FacilityType Waiver

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