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26D2226065 CLIA NUMBER - MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #16385

Laboratory Demographics

CLIA Number: 26D2226065

Facility Name: MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #16385

Facility Address:
202 SIEMERS DR
CAPE GIRARDEAU, MO
ZIP 63701
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043817323

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name Field Value
CLIA Number 26D2226065
LAB Type Pharmacy
Facility Name MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #16385
Street 202 SIEMERS DR
City CAPE GIRARDEAU
State MO
ZIP 63701
Phone 866 389-2727
CertificateType 4
CertificateEffectiveDate 5/26/2023
CertificateExpirationDate 5/25/2025
FacilityType Waiver

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