11D2040440 CLIA NUMBER - WALGREENS #07134

Laboratory Demographics

  • CLIA Code: 11D2040440
  • Facility Name: WALGREENS #07134
  • Facility Address: 110 HAWTHORNE AVENUE
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 543-2951
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNY J. DIXON
  • NPI Number: 1225043334
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2040440
LAB Type Pharmacy
Facility Name WALGREENS #07134
Street 110 HAWTHORNE AVENUE
City ATHENS
State GA
ZIP 30606
Phone 706 543-2951
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Pharmacy
Lab Director JENNY J. DIXON

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