32D2216617 CLIA NUMBER - CVS PHARMACY, INC DBA CVS/PHARMACY #17124

Laboratory Demographics

CLIA Number: 32D2216617

Facility Name: CVS PHARMACY, INC DBA CVS/PHARMACY #17124

Facility Address:
6100 PASEO DEL NORTE NE
ALBUQUERQUE, NM
ZIP 87113
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1417979030

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	32D2216617
LAB Type	Pharmacy
Facility Name	CVS PHARMACY, INC DBA CVS/PHARMACY #17124
Street	6100 PASEO DEL NORTE NE
City	ALBUQUERQUE
State	NM
ZIP	87113
Phone	401 770-6431
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