26D2225340 CLIA NUMBER - MISSOURI CVS PHARMACY, LLC CVS/PHARMACY #05719

Laboratory Demographics

  • CLIA Code: 26D2225340
  • Facility Name: MISSOURI CVS PHARMACY, LLC CVS/PHARMACY #05719
  • Facility Address: 621 SW 3RD ST
    LEES SUMMIT, MO
    ZIP 64063
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRAN NUONG
  • NPI Number: 1164466538
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2225340
LAB Type Pharmacy
Facility Name MISSOURI CVS PHARMACY, LLC CVS/PHARMACY #05719
Street 621 SW 3RD ST
City LEES SUMMIT
State MO
ZIP 64063
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Pharmacy
Lab Director TRAN NUONG

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