39D2282284 CLIA NUMBER - CVS/PHARMACY #01587

Laboratory Demographics

CLIA Number: 39D2282284

Facility Name: CVS/PHARMACY #01587

Facility Address:
202 4TH ST
HONESDALE, PA
ZIP 18431
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Facility Phone Number: 570 253-1730

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1720182553

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	39D2282284
LAB Type	Pharmacy
Facility Name	CVS/PHARMACY #01587
Street	202 4TH ST
City	HONESDALE
State	PA
ZIP	18431
Phone	570 253-1730
CertificateType	4
CertificateEffectiveDate	5/19/2023
CertificateExpirationDate	5/18/2025
FacilityType	Waiver

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