11D2282576 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07068

Laboratory Demographics

  • CLIA Code: 11D2282576
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07068
  • Facility Address: 100 CARRIAGE OAKS
    TYRONE, GA
    ZIP 30290
  • Facility Phone: 770 774-1564
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEREK MCELVEEN
  • NPI Number: 1033213970
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2282576
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #07068
Street 100 CARRIAGE OAKS
City TYRONE
State GA
ZIP 30290
Phone 770 774-1564
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 DEREK MCELVEEN

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