39D2283859 CLIA NUMBER - CVS/PHARMACY #01588

Laboratory Demographics

  • CLIA Code: 39D2283859
  • Facility Name: CVS/PHARMACY #01588
  • Facility Address: 1096 WYOMING AVE, MIDWAY S/C
    WYOMING, PA
    ZIP 18644
  • Facility Phone: 570 693-0280
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXA L. DOSIAK
  • NPI Number: 1396843025
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2283859
LAB Type Pharmacy
Facility Name CVS/PHARMACY #01588
Street 1096 WYOMING AVE, MIDWAY S/C
City WYOMING
State PA
ZIP 18644
Phone 570 693-0280
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Pharmacy
Lab Director ALEXA L. DOSIAK

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