11D2184965 CLIA NUMBER - INGLES MARKET, INC (INGLES PHARMACY #469)

Laboratory Demographics

  • CLIA Code: 11D2184965
  • Facility Name: INGLES MARKET, INC (INGLES PHARMACY #469)
  • Facility Address: 2455 SALEM ROAD ROAD SE
    CONYERS, GA
    ZIP 30013
  • Facility Phone: 770 992-3507
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAROLINE CECKA
  • NPI Number: 1689689531
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2184965
LAB Type Pharmacy
Facility Name INGLES MARKET, INC (INGLES PHARMACY #469)
Street 2455 SALEM ROAD ROAD SE
City CONYERS
State GA
ZIP 30013
Phone 770 992-3507
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Pharmacy
Lab Director CAROLINE CECKA

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