11D2206713 CLIA NUMBER - GOODSON DRUG CO

Laboratory Demographics

  • CLIA Code: 11D2206713
  • Facility Name: GOODSON DRUG CO
  • Facility Address: 116 W MAPLE ST
    CUMMING, GA
    ZIP 30040
  • Facility Phone: 770 887-5040
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: LEE GOODSON
  • NPI Number: 1174609655
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 11D2206713
LAB Type Independent
Facility Name GOODSON DRUG CO
Street 116 W MAPLE ST
City CUMMING
State GA
ZIP 30040
Phone 770 887-5040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Independent
Lab Director LEE GOODSON

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