33D2280983 CLIA NUMBER - CVS PHARMACY NO 02042

Laboratory Demographics

  • CLIA Code: 33D2280983
  • Facility Name: CVS PHARMACY NO 02042
  • Facility Address: 977 JERICHO TURNPIKE
    SMITHTOWN, NY
    ZIP 11787
  • Facility Phone: 631 265-7143
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. SUNGRIM LEE
  • NPI Number: 1255435004
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2280983
LAB Type Pharmacy
Facility Name CVS PHARMACY NO 02042
Street 977 JERICHO TURNPIKE
City SMITHTOWN
State NY
ZIP 11787
Phone 631 265-7143
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2023
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director DR. SUNGRIM LEE

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