11D2042703 CLIA NUMBER - WALGREENS #11538

Laboratory Demographics

  • CLIA Code: 11D2042703
  • Facility Name: WALGREENS #11538
  • Facility Address: 4210 AUGUSTA ROAD
    GARDEN CITY, GA
    ZIP 31408
  • Facility Phone: 912 964-4311
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE L. HARRIS
  • NPI Number: 1346403045
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2042703
LAB Type Pharmacy
Facility Name WALGREENS #11538
Street 4210 AUGUSTA ROAD
City GARDEN CITY
State GA
ZIP 31408
Phone 912 964-4311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director STEPHANIE L. HARRIS

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