11D2034213 CLIA NUMBER - WALGREENS #10632

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Laboratory Demographics

CLIA Number: 11D2034213

Facility Name: WALGREENS #10632

Facility Address:
1602 N EXPRESSWAY
GRIFFIN, GA
ZIP 30223
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Facility Phone Number: 770 227-3397

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1093997983

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	11D2034213
LAB Type	Pharmacy
Facility Name	WALGREENS #10632
Street	1602 N EXPRESSWAY
City	GRIFFIN
State	GA
ZIP	30223
Phone	770 227-3397
CertificateType	4
CertificateEffectiveDate	5/26/2023
CertificateExpirationDate	5/25/2025
FacilityType	Waiver

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