33D2280997 CLIA NUMBER - CVS PHARMACY NO 06045

Laboratory Demographics

  • CLIA Code: 33D2280997
  • Facility Name: CVS PHARMACY NO 06045
  • Facility Address: 1571 FOREST AVE
    STATEN ISLAND, NY
    ZIP 10302
  • Facility Phone: 718 448-8744
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. DIANA R. KEDDIS
  • NPI Number: 1134222961
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2280997
LAB Type Pharmacy
Facility Name CVS PHARMACY NO 06045
Street 1571 FOREST AVE
City STATEN ISLAND
State NY
ZIP 10302
Phone 718 448-8744
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. DIANA R. KEDDIS

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