11D1042596 CLIA NUMBER - CLINIC DRUG STORE

Laboratory Demographics

  • CLIA Code: 11D1042596
  • Facility Name: CLINIC DRUG STORE
  • Facility Address: 1001 EAST FORSYTH STREET
    AMERICUS, GA
    ZIP 31709
  • Facility Phone: 229 924-1760
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LEE F. PINNELL
  • NPI Number: 1073582920
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D1042596
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CLINIC DRUG STORE
Street 1001 EAST FORSYTH STREET
City AMERICUS
State GA
ZIP 31709
Phone 229 924-1760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2025
Certificate Expiration Date 7/4/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LEE F. PINNELL

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