11D2034174 CLIA NUMBER - WALGREENS #12921

Laboratory Demographics

  • CLIA Code: 11D2034174
  • Facility Name: WALGREENS #12921
  • Facility Address: 3625 BATTLEFIELD PARKWAY
    FORT OGLETHORPE, GA
    ZIP 30742
  • Facility Phone: 706 866-1839
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY K. BROWN
  • NPI Number: 1457584559
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2034174
LAB Type Pharmacy
Facility Name WALGREENS #12921
Street 3625 BATTLEFIELD PARKWAY
City FORT OGLETHORPE
State GA
ZIP 30742
Phone 706 866-1839
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director JEFFREY K. BROWN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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