46D2221758 CLIA NUMBER - UTAH CVS PHARMACY, LLC DBA CVS/PHARMACY #17232

Laboratory Demographics

CLIA Number: 46D2221758

Facility Name: UTAH CVS PHARMACY, LLC DBA CVS/PHARMACY #17232

Facility Address:
7779 S JORDAN LANDING BLVD
WEST JORDAN, UT
ZIP 84084
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1366819963

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	46D2221758
LAB Type	Pharmacy
Facility Name	UTAH CVS PHARMACY, LLC DBA CVS/PHARMACY #17232
Street	7779 S JORDAN LANDING BLVD
City	WEST JORDAN
State	UT
ZIP	84084
Phone	866 389-2727
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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