11D2103430 CLIA NUMBER - WIGGINS FAMILY PHARMACY

Laboratory Demographics

  • CLIA Code: 11D2103430
  • Facility Name: WIGGINS FAMILY PHARMACY
  • Facility Address: 1128 S PARK ST
    CARROLLTON, GA
    ZIP 30117
  • Facility Phone: 770 836-0770
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARA M. TRAYLOR
  • NPI Number: 1265562656
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2103430
LAB Type Pharmacy
Facility Name WIGGINS FAMILY PHARMACY
Street 1128 S PARK ST
City CARROLLTON
State GA
ZIP 30117
Phone 770 836-0770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2025
Certificate Expiration Date 10/12/2027
Facility Type Pharmacy
Lab Director SARA M. TRAYLOR

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