26D2064803 CLIA NUMBER - MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #18045

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Laboratory Demographics

CLIA Number: 26D2064803

Facility Name: MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #18045

Facility Address:
5434 SOUTHFIELD CENTER
SAINT LOUIS, MO
ZIP 63123
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1629004973

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	26D2064803
LAB Type	Pharmacy
Facility Name	MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #18045
Street	5434 SOUTHFIELD CENTER
City	SAINT LOUIS
State	MO
ZIP	63123
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	8/27/2023
CertificateExpirationDate	8/26/2025
FacilityType	Waiver

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