11D2249847 CLIA NUMBER - CONNECT CARE PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 11D2249847
  • Facility Name: CONNECT CARE PHARMACY, LLC
  • Facility Address: 2191 GA HIGHWAY, 247 CONNECTOR
    BYRON, GA
    ZIP 31008
  • Facility Phone: 478 654-5222
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GULLIANO FORTUNE
  • NPI Number: 1417598327
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2249847
LAB Type Pharmacy
Facility Name CONNECT CARE PHARMACY, LLC
Street 2191 GA HIGHWAY, 247 CONNECTOR
City BYRON
State GA
ZIP 31008
Phone 478 654-5222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Pharmacy
Lab Director GULLIANO FORTUNE

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