36D2279512 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #04483

Laboratory Demographics

CLIA Number: 36D2279512

Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #04483

Facility Address:
4777 SAWMILL RD, GALLERIA TOWNE CENTRE
COLUMBUS, OH
ZIP 43220
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Facility Phone Number: 614 459-7641

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1801990627

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 36D2279512
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #04483
Street 4777 SAWMILL RD, GALLERIA TOWNE CENTRE
City COLUMBUS
State OH
ZIP 43220
Phone 614 459-7641
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