11D2223518 CLIA NUMBER - GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #10043

Laboratory Demographics

CLIA Number: 11D2223518

Facility Name: GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #10043

Facility Address:
235 PEACHTREE STREET NE SUITE C24
ATLANTA, GA
ZIP 30303
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1801153093

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	11D2223518
LAB Type	Pharmacy
Facility Name	GEORGIA CVS PHARMACY,LLC DBA CVS/PHARMACY #10043
Street	235 PEACHTREE STREET NE SUITE C24
City	ATLANTA
State	GA
ZIP	30303
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