36D2279450 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #05364

Laboratory Demographics

  • CLIA Code: 36D2279450
  • Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #05364
  • Facility Address: 2375 BEECHWOOD DR
    GERMANTOWN, OH
    ZIP 45327
  • Facility Phone: 937 855-7296
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EVAN LUKSIC
  • NPI Number: 1629171459
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2279450
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #05364
Street 2375 BEECHWOOD DR
City GERMANTOWN
State OH
ZIP 45327
Phone 937 855-7296
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Pharmacy
Lab Director EVAN LUKSIC

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