36D2279296 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #03333

Laboratory Demographics

  • CLIA Code: 36D2279296
  • Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #03333
  • Facility Address: 3171 WEST BLVD
    CLEVELAND, OH
    ZIP 44111
  • Facility Phone: 216 281-3061
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAELYN PORVASNIK
  • NPI Number: 1700093689
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2279296
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #03333
Street 3171 WEST BLVD
City CLEVELAND
State OH
ZIP 44111
Phone 216 281-3061
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director KAELYN PORVASNIK

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