11D1042597 CLIA NUMBER - RIVERSIDE PHARMACY

Laboratory Demographics

  • CLIA Code: 11D1042597
  • Facility Name: RIVERSIDE PHARMACY
  • Facility Address: 935 GREEN STREET
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 770 532-6253
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN WAYNE GEE
  • NPI Number: 1982761706
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D1042597
LAB Type Pharmacy
Facility Name RIVERSIDE PHARMACY
Street 935 GREEN STREET
City GAINESVILLE
State GA
ZIP 30501
Phone 770 532-6253
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2025
Certificate Expiration Date 7/4/2027
Facility Type Pharmacy
Lab Director JOHN WAYNE GEE

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