11D2281747 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBS CVS/PHARMACY #04553

Laboratory Demographics

  • CLIA Code: 11D2281747
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBS CVS/PHARMACY #04553
  • Facility Address: 202 GRAYSON HIGHWAY
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 770 963-8183
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA NEWSOM
  • NPI Number: 1770686438
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2281747
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBS CVS/PHARMACY #04553
Street 202 GRAYSON HIGHWAY
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 963-8183
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director ANGELA NEWSOM

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