11D2042200 CLIA NUMBER - WALGREENS 07848

Laboratory Demographics

  • CLIA Code: 11D2042200
  • Facility Name: WALGREENS 07848
  • Facility Address: 4575 ALTAMA AVENUE
    BRUNSWICK, GA
    ZIP 31520
  • Facility Phone: 912 261-2593
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. WENDY B. MATHIS
  • NPI Number: 1306369913
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2042200
LAB Type Pharmacy
Facility Name WALGREENS 07848
Street 4575 ALTAMA AVENUE
City BRUNSWICK
State GA
ZIP 31520
Phone 912 261-2593
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director MS. WENDY B. MATHIS

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