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

Laboratory Demographics

CLIA Number: 45D2282769

Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #01792

Facility Address:
4201 E PARK AVE
PLANO, TX
ZIP 75074
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Facility Phone Number: 972 424-0067

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1912004318

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	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
CertificateType	4
CertificateEffectiveDate	5/25/2023
CertificateExpirationDate	5/24/2025
FacilityType	Waiver

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