36D2279485 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #03447

Laboratory Demographics

  • CLIA Code: 36D2279485
  • Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #03447
  • Facility Address: 4901 N MAIN ST
    DAYTON, OH
    ZIP 45415
  • Facility Phone: 937 278-5871
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROGER DAVIDSON
  • NPI Number: 1215030663
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2279485
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #03447
Street 4901 N MAIN ST
City DAYTON
State OH
ZIP 45415
Phone 937 278-5871
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 ROGER DAVIDSON

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This page was last updated on: 6/4/2025