11D2050226 CLIA NUMBER - WALGREEN 10602

Laboratory Demographics

  • CLIA Code: 11D2050226
  • Facility Name: WALGREEN 10602
  • Facility Address: 4310 WASHINGTON ROAD
    EVANS, GA
    ZIP 30809
  • Facility Phone: 706 860-4179
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATIE B. GUYTON
  • NPI Number: 1790925691
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2050226
LAB Type Pharmacy
Facility Name WALGREEN 10602
Street 4310 WASHINGTON ROAD
City EVANS
State GA
ZIP 30809
Phone 706 860-4179
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2023
Certificate Expiration Date 8/10/2025
Facility Type Pharmacy
Lab Director KATIE B. GUYTON

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This page was last updated on: 6/4/2025