Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
FQHCLA482 NOALAB CLINIC INC

Covered Entity Details

Entity Name

NOALAB CLINIC INC

Subdivision Name

Noalab Community Healthcare - Coldwater Canyon

Type

Health Center Program Look-Alike

340B ID

FQHCLA482

Entity Address

6428 Coldwater Canyon Ave
North Hollywood, CA 91606-1113

Grant Number

LALCS54729

Participating Start Date

4/1/2025

Last Recertification Date

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04792
15232 SHERMAN WAY
VAN NUYS, CA 91405

Pharmacy Comments

Contract Details

Approval Date

4/2/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lukash Abrahamyan, CEO
(818) 648-0044

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/2/2025

340B Drug Pricing Program Database