36D2279301 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #03340

Laboratory Demographics

  • CLIA Code: 36D2279301
  • Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #03340
  • Facility Address: 15501 DETROIT AVE
    LAKEWOOD, OH
    ZIP 44107
  • Facility Phone: 216 221-7961
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANA SOLDATO
  • NPI Number: 1548363252
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2279301
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #03340
Street 15501 DETROIT AVE
City LAKEWOOD
State OH
ZIP 44107
Phone 216 221-7961
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 DANA SOLDATO

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