11D2282919 CLIA NUMBER - GEORGIA CVS PHARMACY, LLC CVS/PHARMACY #04178

Laboratory Demographics

  • CLIA Code: 11D2282919
  • Facility Name: GEORGIA CVS PHARMACY, LLC CVS/PHARMACY #04178
  • Facility Address: 895 RALPH ABERNATHY BOULEVARD, SW
    ATLANTA, GA
    ZIP 30310
  • Facility Phone: 404 755-1511
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HOANGTRAN DANG
  • NPI Number: 1205939956
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2282919
LAB Type Pharmacy
Facility Name GEORGIA CVS PHARMACY, LLC CVS/PHARMACY #04178
Street 895 RALPH ABERNATHY BOULEVARD, SW
City ATLANTA
State GA
ZIP 30310
Phone 404 755-1511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Pharmacy
Lab Director HOANGTRAN DANG

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