49D2283468 CLIA NUMBER - VIRGINIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07577

Laboratory Demographics

  • CLIA Code: 49D2283468
  • Facility Name: VIRGINIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07577
  • Facility Address: 4126 PLANTATION ROAD
    ROANOKE, VA
    ZIP 24012
  • Facility Phone: 540 563-4968
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMERA TICKLE
  • NPI Number: 1073616710
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2283468
LAB Type Pharmacy
Facility Name VIRGINIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07577
Street 4126 PLANTATION ROAD
City ROANOKE
State VA
ZIP 24012
Phone 540 563-4968
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Pharmacy
Lab Director TAMERA TICKLE

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