11D2255743 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04506

Laboratory Demographics

  • CLIA Code: 11D2255743
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04506
  • Facility Address: 402 N WALL STREET
    CALHOUN, GA
    ZIP 30701
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BROOKE HYDE
  • NPI Number: 1699878439
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2255743
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04506
Street 402 N WALL STREET
City CALHOUN
State GA
ZIP 30701
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 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Pharmacy
Lab Director BROOKE HYDE

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