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37D2224229 CLIA NUMBER - CVS/PHARMACY #06021 OKLAHOMA CVS PHARMACY, LLC

Laboratory Demographics

CLIA Number: 37D2224229

Facility Name: CVS/PHARMACY #06021 OKLAHOMA CVS PHARMACY, LLC

Facility Address:
800 SE 4TH ST
MOORE, OK
ZIP 73160
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Facility Phone Number: 401 765-1500

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1568756963

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 37D2224229
LAB Type Pharmacy
Facility Name CVS/PHARMACY #06021 OKLAHOMA CVS PHARMACY, LLC
Street 800 SE 4TH ST
City MOORE
State OK
ZIP 73160
Phone 401 765-1500
CertificateType 4
CertificateEffectiveDate 5/12/2023
CertificateExpirationDate 5/11/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024