01D2219494 CLIA NUMBER - WALGREENS #11115

Laboratory Demographics

  • CLIA Code: 01D2219494
  • Facility Name: WALGREENS #11115
  • Facility Address: 33495 HIGHWAY 43
    THOMASVILLE, AL
    ZIP 36784
  • Facility Phone: 334 636-8420
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOSES B. IGAMBA
  • NPI Number: 1619145976
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2219494
LAB Type Pharmacy
Facility Name WALGREENS #11115
Street 33495 HIGHWAY 43
City THOMASVILLE
State AL
ZIP 36784
Phone 334 636-8420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director MOSES B. IGAMBA

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