11D2282805 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #05621

Laboratory Demographics

  • CLIA Code: 11D2282805
  • Facility Name: GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #05621
  • Facility Address: 3030 HEADLAND DRIVE
    ATLANTA, GA
    ZIP 30311
  • Facility Phone: 404 346-1423
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLAWALE OLAGBENDE
  • NPI Number: 1538262373
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2282805
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC DBA CVS/PHARMACY #05621
Street 3030 HEADLAND DRIVE
City ATLANTA
State GA
ZIP 30311
Phone 404 346-1423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director OLAWALE OLAGBENDE

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