33D2280988 CLIA NUMBER - CVS PHARMACY NO 03382

Laboratory Demographics

  • CLIA Code: 33D2280988
  • Facility Name: CVS PHARMACY NO 03382
  • Facility Address: 29 HAVENWOOD DR
    SHIRLEY, NY
    ZIP 11967
  • Facility Phone: 631 395-4108
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. DONIEL M. SIMON
  • NPI Number: 1497910152
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2280988
LAB Type Pharmacy
Facility Name CVS PHARMACY NO 03382
Street 29 HAVENWOOD DR
City SHIRLEY
State NY
ZIP 11967
Phone 631 395-4108
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. DONIEL M. SIMON

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