11D2034628 CLIA NUMBER - WALGREENS #11794

Laboratory Demographics

  • CLIA Code: 11D2034628
  • Facility Name: WALGREENS #11794
  • Facility Address: 11343 US HIGHWAY 319 N
    THOMASVILLE, GA
    ZIP 31757
  • Facility Phone: 229 226-5424
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LESHA M. COLLA
  • NPI Number: 1649449596
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034628
LAB Type Pharmacy
Facility Name WALGREENS #11794
Street 11343 US HIGHWAY 319 N
City THOMASVILLE
State GA
ZIP 31757
Phone 229 226-5424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director LESHA M. COLLA

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