11D2282011 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #03773

Laboratory Demographics

  • CLIA Code: 11D2282011
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #03773
  • Facility Address: 802 NORTH HOUSTON ROAD
    WARNER ROBINS, GA
    ZIP 31093
  • Facility Phone: 478 923-5501
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK EASTMAN-MOORE
  • NPI Number: 1710232913
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2282011
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #03773
Street 802 NORTH HOUSTON ROAD
City WARNER ROBINS
State GA
ZIP 31093
Phone 478 923-5501
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 MARK EASTMAN-MOORE

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