45D2282769 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #01792

Laboratory Demographics

  • CLIA Code: 45D2282769
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #01792
  • Facility Address: 4201 E PARK AVE
    PLANO, TX
    ZIP 75074
  • Facility Phone: 972 424-0067
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VINCENT NGUYEN
  • NPI Number: 1912004318
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2282769
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #01792
Street 4201 E PARK AVE
City PLANO
State TX
ZIP 75074
Phone 972 424-0067
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director VINCENT NGUYEN

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