11D2282477 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC CVS/PGARMACY #00792

Laboratory Demographics

  • CLIA Code: 11D2282477
  • Facility Name: GEORGIA CVS PHARMACY, LLC CVS/PGARMACY #00792
  • Facility Address: 4050 WINDER HWY
    FLOWERY BRANCH, GA
    ZIP 30542
  • Facility Phone: (770) 965-1979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DUSTY HARDGE
  • NPI Number: 1184840142
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2282477
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC CVS/PGARMACY #00792
Street 4050 WINDER HWY
City FLOWERY BRANCH
State GA
ZIP 30542
Phone 7709651979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Pharmacy
Lab Director DUSTY HARDGE

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This page was last updated on: 5/18/2026