11D2281510 CLIA NUMBER - GEORGIA CVS PHRMACY, LLC DBA CVS/PHARMACY #02146

Laboratory Demographics

  • CLIA Code: 11D2281510
  • Facility Name: GEORGIA CVS PHRMACY, LLC DBA CVS/PHARMACY #02146
  • Facility Address: 4345 SOUTH COBB DRIVE, SE
    SMYRNA, GA
    ZIP 30080
  • Facility Phone: 770 438-5042
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE KINNON
  • NPI Number: 1164526091
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2281510
LAB Type Pharmacy
Facility Name GEORGIA CVS PHRMACY, LLC DBA CVS/PHARMACY #02146
Street 4345 SOUTH COBB DRIVE, SE
City SMYRNA
State GA
ZIP 30080
Phone 770 438-5042
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Pharmacy
Lab Director JACQUELINE KINNON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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