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39D2224806 CLIA NUMBER - CVS/PHARMACY #01686

Laboratory Demographics

CLIA Number: 39D2224806

Facility Name: CVS/PHARMACY #01686

Facility Address:
236 GRANT STREET
JOHNSONBURG, PA
ZIP 15845
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1467556217

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 39D2224806
LAB Type Pharmacy
Facility Name CVS/PHARMACY #01686
Street 236 GRANT STREET
City JOHNSONBURG
State PA
ZIP 15845
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 5/17/2023
CertificateExpirationDate 5/16/2025
FacilityType Waiver

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