11D2034338 CLIA NUMBER - WALGREENS #11940

Laboratory Demographics

  • CLIA Code: 11D2034338
  • Facility Name: WALGREENS #11940
  • Facility Address: 274 W CLINTON ROAD
    GRAY, GA
    ZIP 31032
  • Facility Phone: 478 986-5146
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARON BOWDEN
  • NPI Number: 1215108931
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2034338
LAB Type Pharmacy
Facility Name WALGREENS #11940
Street 274 W CLINTON ROAD
City GRAY
State GA
ZIP 31032
Phone 478 986-5146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Pharmacy
Lab Director CHARON BOWDEN

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