11D2219563 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04260

Home > CLIA Lookup > 11D2219563

Laboratory Demographics

CLIA Number: 11D2219563

Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04260

Facility Address:
4725 WATERS AVENUE
SAVANNAH, GA
ZIP 31404
Get Directions

Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1164616249

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	11D2219563
LAB Type	Pharmacy
Facility Name	GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04260
Street	4725 WATERS AVENUE
City	SAVANNAH
State	GA
ZIP	31404
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	4/6/2023
CertificateExpirationDate	4/5/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024