11D2281215 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04565

Laboratory Demographics

  • CLIA Code: 11D2281215
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04565
  • Facility Address: 960 N COLUMBIA STREET
    MILLEDGEVILLE, GA
    ZIP 31061
  • Facility Phone: (478) 452-5533
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASIA LOGAN
  • NPI Number: 1942303466
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2281215
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04565
Street 960 N COLUMBIA STREET
City MILLEDGEVILLE
State GA
ZIP 31061
Phone 4784525533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director ASIA LOGAN

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This page was last updated on: 5/18/2026