45D2219950 CLIA NUMBER - CVS PHARMACY, INC DBA CVS/PHARMACY #06247

Laboratory Demographics

  • CLIA Code: 45D2219950
  • Facility Name: CVS PHARMACY, INC DBA CVS/PHARMACY #06247
  • Facility Address: 1610 NASA RD 1
    NASSAU BAY, TX
    ZIP 77058
  • Facility Phone: (401) 770-6431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMER SULTAN
  • NPI Number: 1609970482
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2219950
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVS/PHARMACY #06247
Street 1610 NASA RD 1
City NASSAU BAY
State TX
ZIP 77058
Phone 4017706431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director SAMER SULTAN

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This page was last updated on: 5/18/2026