36D2279514 CLIA NUMBER - OHIO CVS STORES, LLC CVS/PHARMACY #04606

Laboratory Demographics

  • CLIA Code: 36D2279514
  • Facility Name: OHIO CVS STORES, LLC CVS/PHARMACY #04606
  • Facility Address: 620 E MARKET ST
    WARREN, OH
    ZIP 44481
  • Facility Phone: 330 393-5205
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTIN KELLY
  • NPI Number: 1376646109
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2279514
LAB Type Pharmacy
Facility Name OHIO CVS STORES, LLC CVS/PHARMACY #04606
Street 620 E MARKET ST
City WARREN
State OH
ZIP 44481
Phone 330 393-5205
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 MARTIN KELLY

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