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11D2282789 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04515

Laboratory Demographics

CLIA Number: 11D2282789

Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04515

Facility Address:
14857 US HWY 19 S
THOMASVILLE, GA
ZIP 31792
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Facility Phone Number: 229 228-7785

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1588767230

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 11D2282789
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #04515
Street 14857 US HWY 19 S
City THOMASVILLE
State GA
ZIP 31792
Phone 229 228-7785
CertificateType 4
CertificateEffectiveDate 5/25/2023
CertificateExpirationDate 5/24/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024