11D2223484 CLIA NUMBER - GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #03125

Laboratory Demographics

  • CLIA Code: 11D2223484
  • Facility Name: GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #03125
  • Facility Address: 895 HOLCOMB BRIDGE ROAD
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FARRAH KASEMKHANI
  • NPI Number: 1215031158
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2223484
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #03125
Street 895 HOLCOMB BRIDGE ROAD
City ROSWELL
State GA
ZIP 30076
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Pharmacy
Lab Director FARRAH KASEMKHANI

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