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46D2218053 CLIA NUMBER - UTAH CVS PHARMACY, LLC DBA CVS/PHARMACY #16879

Laboratory Demographics

CLIA Number: 46D2218053

Facility Name: UTAH CVS PHARMACY, LLC DBA CVS/PHARMACY #16879

Facility Address:
10130 S STATE ST
SANDY, UT
ZIP 84070
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Facility Phone Number: 401 765-1500

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1992727671

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 46D2218053
LAB Type Pharmacy
Facility Name UTAH CVS PHARMACY, LLC DBA CVS/PHARMACY #16879
Street 10130 S STATE ST
City SANDY
State UT
ZIP 84070
Phone 401 765-1500
CertificateType 4
CertificateEffectiveDate 3/25/2023
CertificateExpirationDate 3/24/2025
FacilityType Waiver

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