11D2281980 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #02281

Laboratory Demographics

  • CLIA Code: 11D2281980
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #02281
  • Facility Address: 10307 TARA BOULEVARD
    JONESBORO, GA
    ZIP 30236
  • Facility Phone: 770 210-3400
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHIVANI PATEL
  • NPI Number: 1558465484
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2281980
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #02281
Street 10307 TARA BOULEVARD
City JONESBORO
State GA
ZIP 30236
Phone 770 210-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2025
Certificate Expiration Date 5/15/2027
Facility Type Pharmacy
Lab Director SHIVANI PATEL

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