45D2282991 CLIA NUMBER - CVS PHARMACY, INC DBA CVS/PHARMACY #10664

Laboratory Demographics

  • CLIA Code: 45D2282991
  • Facility Name: CVS PHARMACY, INC DBA CVS/PHARMACY #10664
  • Facility Address: 2180 WOODFOREST PARKWAY N
    MONTGOMERY, TX
    ZIP 77316
  • Facility Phone: 936 588-6061
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOVAN DUDLEY
  • NPI Number: 1114302122
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2282991
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVS/PHARMACY #10664
Street 2180 WOODFOREST PARKWAY N
City MONTGOMERY
State TX
ZIP 77316
Phone 936 588-6061
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Pharmacy
Lab Director JOVAN DUDLEY

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