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36D2216675 CLIA NUMBER - OHIO CVS STORES, LLC DBA CVS/PHARMACY #11396

Laboratory Demographics

CLIA Number: 36D2216675

Facility Name: OHIO CVS STORES, LLC DBA CVS/PHARMACY #11396

Facility Address:
119 NORTH MARKET
SHREVE, OH
ZIP 44676
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1316952955

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 36D2216675
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC DBA CVS/PHARMACY #11396
Street 119 NORTH MARKET
City SHREVE
State OH
ZIP 44676
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