11D2187360 CLIA NUMBER - LEE-GOODRUM PHARMACY

Laboratory Demographics

  • CLIA Code: 11D2187360
  • Facility Name: LEE-GOODRUM PHARMACY
  • Facility Address: 40 HOSPTIAL ROAD
    NEWNAN, GA
    ZIP 30263
  • Facility Phone: 770 253-1121
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY A. TARPLEY
  • NPI Number: 1053332015
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2187360
LAB Type Pharmacy
Facility Name LEE-GOODRUM PHARMACY
Street 40 HOSPTIAL ROAD
City NEWNAN
State GA
ZIP 30263
Phone 770 253-1121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Pharmacy
Lab Director CASEY A. TARPLEY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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