11D2282561 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07746

Laboratory Demographics

  • CLIA Code: 11D2282561
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07746
  • Facility Address: 2559 WINDSOR SPRING ROAD
    AUGUSTA, GA
    ZIP 30906
  • Facility Phone: 706 796-8146
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOSTAFA KHATER
  • NPI Number: 1255434072
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2282561
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07746
Street 2559 WINDSOR SPRING ROAD
City AUGUSTA
State GA
ZIP 30906
Phone 706 796-8146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Pharmacy
Lab Director MOSTAFA KHATER

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