11D2281661 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #05444

Laboratory Demographics

  • CLIA Code: 11D2281661
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #05444
  • Facility Address: 3674 HIGHWAY 5
    DOUGLASVILLE, GA
    ZIP 30135
  • Facility Phone: (770) 942-3153
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLUWASEYI HAMBOLU
  • NPI Number: 1811256605
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2281661
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #05444
Street 3674 HIGHWAY 5
City DOUGLASVILLE
State GA
ZIP 30135
Phone 7709423153
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Pharmacy
Lab Director OLUWASEYI HAMBOLU

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: 5/18/2026