11D2281749 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PAHRMACY #04730

Laboratory Demographics

  • CLIA Code: 11D2281749
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PAHRMACY #04730
  • Facility Address: 1187 GRAYSON HIGHWAY
    LAWRENCEVILLE, GA
    ZIP 30045
  • Facility Phone: 770 338-2513
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SALI DEO
  • NPI Number: 1366617433
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2281749
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PAHRMACY #04730
Street 1187 GRAYSON HIGHWAY
City LAWRENCEVILLE
State GA
ZIP 30045
Phone 770 338-2513
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 SALI DEO

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