11D0997911 CLIA NUMBER - WILKES APOTHECARY, LLC DBA FIEVET PHARMACY

Laboratory Demographics

CLIA Number: 11D0997911

Facility Name: WILKES APOTHECARY, LLC DBA FIEVET PHARMACY

Facility Address:
115 E ROBERT TOOMS AVENUE
WASHINGTON, GA
ZIP 30673
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Facility Phone Number: 706 678-2260

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1740773167

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	11D0997911
LAB Type	Pharmacy
Facility Name	WILKES APOTHECARY, LLC DBA FIEVET PHARMACY
Street	115 E ROBERT TOOMS AVENUE
City	WASHINGTON
State	GA
ZIP	30673
Phone	706 678-2260
CertificateType	4
CertificateEffectiveDate	4/1/2024
CertificateExpirationDate	3/31/2026
FacilityType	Waiver

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