39D2284374 CLIA NUMBER - CVS/PHARMACY #05462

Laboratory Demographics

  • CLIA Code: 39D2284374
  • Facility Name: CVS/PHARMACY #05462
  • Facility Address: 1991 SPROUL RD
    BROOMALL, PA
    ZIP 19008
  • Facility Phone: 610 325-8422
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES P. TEEPLE
  • NPI Number: 1811091606
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2284374
LAB Type Pharmacy
Facility Name CVS/PHARMACY #05462
Street 1991 SPROUL RD
City BROOMALL
State PA
ZIP 19008
Phone 610 325-8422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Pharmacy
Lab Director JAMES P. TEEPLE

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