11D2223511 CLIA NUMBER - GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #05411

Laboratory Demographics

CLIA Number: 11D2223511

Facility Name: GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #05411

Facility Address:
4600 ROSWELL ROAD SUITE F100
SANDY SPRINGS, GA
ZIP 30342
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1174771521

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	11D2223511
LAB Type	Pharmacy
Facility Name	GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #05411
Street	4600 ROSWELL ROAD SUITE F100
City	SANDY SPRINGS
State	GA
ZIP	30342
Phone	866 389-2727
CertificateType	4
CertificateEffectiveDate	5/7/2023
CertificateExpirationDate	5/6/2025
FacilityType	Waiver

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