45D2225080 CLIA NUMBER - CVS PHARMACY, INC DBA CVS/PHARMACY #05641

Laboratory Demographics

CLIA Number: 45D2225080

Facility Name: CVS PHARMACY, INC DBA CVS/PHARMACY #05641

Facility Address:
1500 PADRE BLVD
SOUTH PADRE ISLAND, TX
ZIP 78597
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134367402

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	45D2225080
LAB Type	Pharmacy
Facility Name	CVS PHARMACY, INC DBA CVS/PHARMACY #05641
Street	1500 PADRE BLVD
City	SOUTH PADRE ISLAND
State	TX
ZIP	78597
Phone	866 389-2727
CertificateType	4
CertificateEffectiveDate	5/18/2023
CertificateExpirationDate	5/17/2025
FacilityType	Waiver

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