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36D2279436 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #03413

Laboratory Demographics

CLIA Number: 36D2279436

Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #03413

Facility Address:
4400 CLEVELAND AVE
COLUMBUS, OH
ZIP 43224
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Facility Phone Number: 614 475-3611

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1013010479

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 36D2279436
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #03413
Street 4400 CLEVELAND AVE
City COLUMBUS
State OH
ZIP 43224
Phone 614 475-3611
CertificateType 4
CertificateEffectiveDate 4/3/2023
CertificateExpirationDate 4/2/2025
FacilityType Waiver

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