11D2034181 CLIA NUMBER - WALGREENS #11994

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Laboratory Demographics

CLIA Number: 11D2034181

Facility Name: WALGREENS #11994

Facility Address:
2225 E WALNUT AVENUE
DALTON, GA
ZIP 30721
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Facility Phone Number: 706 260-2628

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1699935247

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	11D2034181
LAB Type	Pharmacy
Facility Name	WALGREENS #11994
Street	2225 E WALNUT AVENUE
City	DALTON
State	GA
ZIP	30721
Phone	706 260-2628
CertificateType	4
CertificateEffectiveDate	4/7/2023
CertificateExpirationDate	4/6/2025
FacilityType	Waiver

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