39D2259382 CLIA NUMBER - CVS/PHARMACY #01625

Laboratory Demographics

  • CLIA Code: 39D2259382
  • Facility Name: CVS/PHARMACY #01625
  • Facility Address: 1565 W HARRISBURG PIKE
    MIDDLETOWN, PA
    ZIP 17057
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACY A. MARRA
  • NPI Number: 1518065242
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2259382
LAB Type Pharmacy
Facility Name CVS/PHARMACY #01625
Street 1565 W HARRISBURG PIKE
City MIDDLETOWN
State PA
ZIP 17057
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2024
Certificate Expiration Date 5/4/2026
Facility Type Pharmacy
Lab Director TRACY A. MARRA

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