11D2034624 CLIA NUMBER - WALGREENS #10796

Laboratory Demographics

  • CLIA Code: 11D2034624
  • Facility Name: WALGREENS #10796
  • Facility Address: 2414 SYLVESTER ROAD
    ALBANY, GA
    ZIP 31705
  • Facility Phone: 229 430-9119
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIFFACY SOMEREVILLE
  • NPI Number: 1528247012
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034624
LAB Type Pharmacy
Facility Name WALGREENS #10796
Street 2414 SYLVESTER ROAD
City ALBANY
State GA
ZIP 31705
Phone 229 430-9119
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director TIFFACY SOMEREVILLE

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