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36D2217495 CLIA NUMBER - OHIO CVS STORES, LLC DBA CVS/PHARMACY #16379

Laboratory Demographics

CLIA Number: 36D2217495

Facility Name: OHIO CVS STORES, LLC DBA CVS/PHARMACY #16379

Facility Address:
1015 N COURT ST
MEDINA, OH
ZIP 44256
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1598787392

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 36D2217495
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC DBA CVS/PHARMACY #16379
Street 1015 N COURT ST
City MEDINA
State OH
ZIP 44256
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 3/22/2023
CertificateExpirationDate 3/21/2025
FacilityType Waiver

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