11D2034357 CLIA NUMBER - WALGREENS #09643

Laboratory Demographics

  • CLIA Code: 11D2034357
  • Facility Name: WALGREENS #09643
  • Facility Address: 102 RUSSELL PARKWAY
    WARNER ROBINS, GA
    ZIP 31088
  • Facility Phone: 478 642-2064
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THANH DOAN
  • NPI Number: 1003196726
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034357
LAB Type Pharmacy
Facility Name WALGREENS #09643
Street 102 RUSSELL PARKWAY
City WARNER ROBINS
State GA
ZIP 31088
Phone 478 642-2064
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Pharmacy
Lab Director THANH DOAN

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