11D2192620 CLIA NUMBER - HINESVILLE PHARMACY

Laboratory Demographics

  • CLIA Code: 11D2192620
  • Facility Name: HINESVILLE PHARMACY
  • Facility Address: 481 ELMA G MILES PARKWAY
    HINESVILLE, GA
    ZIP 31313
  • Facility Phone: 912 876-8125
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES B. GAY
  • NPI Number: 1184618894
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 11D2192620
LAB Type Pharmacy
Facility Name HINESVILLE PHARMACY
Street 481 ELMA G MILES PARKWAY
City HINESVILLE
State GA
ZIP 31313
Phone 912 876-8125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Pharmacy
Lab Director JAMES B. GAY

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