11D2034355 CLIA NUMBER - WALGREENS #10884

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Laboratory Demographics

CLIA Number: 11D2034355

Facility Name: WALGREENS #10884

Facility Address:
1081 GEORGIA HIGHWAY 96
WARNER ROBINS, GA
ZIP 31088
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Facility Phone Number: 478 987-7494

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1508053018

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	11D2034355
LAB Type	Pharmacy
Facility Name	WALGREENS #10884
Street	1081 GEORGIA HIGHWAY 96
City	WARNER ROBINS
State	GA
ZIP	31088
Phone	478 987-7494
CertificateType	4
CertificateEffectiveDate	4/22/2023
CertificateExpirationDate	4/21/2025
FacilityType	Waiver

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