11D2037126 CLIA NUMBER - WALGREENS 11791

Home > CLIA Lookup > 11D2037126

Laboratory Demographics

CLIA Number: 11D2037126

Facility Name: WALGREENS 11791

Facility Address:
2100 N BROAD STREET
COMMERCE, GA
ZIP 30529
Get Directions

Facility Phone Number: 706 336-5931

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1538305933

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	11D2037126
LAB Type	Pharmacy
Facility Name	WALGREENS 11791
Street	2100 N BROAD STREET
City	COMMERCE
State	GA
ZIP	30529
Phone	706 336-5931
CertificateType	4
CertificateEffectiveDate	8/11/2023
CertificateExpirationDate	8/10/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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