11D0975551 CLIA NUMBER - GORDON DRUG CO

Laboratory Demographics

CLIA Number: 11D0975551

Facility Name: GORDON DRUG CO

Facility Address:
242 MILLEDGEVILLE ROAD
GORDON, GA
ZIP 31031
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Facility Phone Number: 912 628-2425

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1184718942

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	11D0975551
LAB Type	Pharmacy
Facility Name	GORDON DRUG CO
Street	242 MILLEDGEVILLE ROAD
City	GORDON
State	GA
ZIP	31031
Phone	912 628-2425
CertificateType	4
CertificateEffectiveDate	7/11/2022
CertificateExpirationDate	7/10/2024
FacilityType	Waiver

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