34D2281881 CLIA NUMBER - NORTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #04490

Laboratory Demographics

CLIA Number: 34D2281881

Facility Name: NORTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #04490

Facility Address:
2580 COURT DRIVE
GASTONIA, NC
ZIP 28054
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Facility Phone Number: 704 810-3681

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1982707758

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	34D2281881
LAB Type	Pharmacy
Facility Name	NORTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #04490
Street	2580 COURT DRIVE
City	GASTONIA
State	NC
ZIP	28054
Phone	704 810-3681
CertificateType	4
CertificateEffectiveDate	5/12/2023
CertificateExpirationDate	5/11/2025
FacilityType	Waiver

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