11D2034603 CLIA NUMBER - WALGREENS #09277

Laboratory Demographics

  • CLIA Code: 11D2034603
  • Facility Name: WALGREENS #09277
  • Facility Address: 1740 MEMORIAL DRIVE
    WAYCROSS, GA
    ZIP 31501
  • Facility Phone: 912 338-9127
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL C. ALTMAN
  • NPI Number: 1154336279
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034603
LAB Type Pharmacy
Facility Name WALGREENS #09277
Street 1740 MEMORIAL DRIVE
City WAYCROSS
State GA
ZIP 31501
Phone 912 338-9127
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Pharmacy
Lab Director MICHAEL C. ALTMAN

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