36D2279500 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #04316

Laboratory Demographics

  • CLIA Code: 36D2279500
  • Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #04316
  • Facility Address: 6301 HARVARD AVENUE
    CLEVELAND, OH
    ZIP 44105
  • Facility Phone: 216 271-0970
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELVIRA DERVISHI
  • NPI Number: 1811090558
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2279500
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #04316
Street 6301 HARVARD AVENUE
City CLEVELAND
State OH
ZIP 44105
Phone 216 271-0970
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 ELVIRA DERVISHI

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