11D2040440 CLIA NUMBER - WALGREENS #07134

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Laboratory Demographics

CLIA Number: 11D2040440

Facility Name: WALGREENS #07134

Facility Address:
110 HAWTHORNE AVENUE
ATHENS, GA
ZIP 30606
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Facility Phone Number: 706 543-2951

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1225043334

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	11D2040440
LAB Type	Pharmacy
Facility Name	WALGREENS #07134
Street	110 HAWTHORNE AVENUE
City	ATHENS
State	GA
ZIP	30606
Phone	706 543-2951
CertificateType	4
CertificateEffectiveDate	7/21/2023
CertificateExpirationDate	7/20/2025
FacilityType	Waiver

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