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36D2279275 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #03090

Laboratory Demographics

CLIA Number: 36D2279275

Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #03090

Facility Address:
3 NORTH CLEVELAND AVE
MOGADORE, OH
ZIP 44260
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Facility Phone Number: 330 628-1717

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1235233909

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 36D2279275
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #03090
Street 3 NORTH CLEVELAND AVE
City MOGADORE
State OH
ZIP 44260
Phone 330 628-1717
CertificateType 4
CertificateEffectiveDate 3/31/2023
CertificateExpirationDate 3/30/2025
FacilityType Waiver

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