45D2185272 CLIA NUMBER - CVS PHARMACY, INC DBA CVS/PHARMACY #00988

Laboratory Demographics

  • CLIA Code: 45D2185272
  • Facility Name: CVS PHARMACY, INC DBA CVS/PHARMACY #00988
  • Facility Address: 1702 S BROADWAY AVE
    TYLER, TX
    ZIP 75701
  • Facility Phone: 401 770-6431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TONYA NEWSOME
  • NPI Number: 1679677470
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2185272
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVS/PHARMACY #00988
Street 1702 S BROADWAY AVE
City TYLER
State TX
ZIP 75701
Phone 401 770-6431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2024
Certificate Expiration Date 6/1/2026
Facility Type Pharmacy
Lab Director TONYA NEWSOME

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