11D2281754 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #02187

Laboratory Demographics

  • CLIA Code: 11D2281754
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #02187
  • Facility Address: 5846-5856 MABELTON PARKWAY
    MABLETON, GA
    ZIP 30126
  • Facility Phone: 770 745-3171
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HARRISON BEASLEY
  • NPI Number: 1093819922
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2281754
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #02187
Street 5846-5856 MABELTON PARKWAY
City MABLETON
State GA
ZIP 30126
Phone 770 745-3171
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 HARRISON BEASLEY

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