11D2203197 CLIA NUMBER - FOREST HEIGHTS PHARMACY

Laboratory Demographics

  • CLIA Code: 11D2203197
  • Facility Name: FOREST HEIGHTS PHARMACY
  • Facility Address: 4439 COUNTRY CLUB ROAD
    STATESBORO, GA
    ZIP 30458
  • Facility Phone: 912 489-7979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BENJAMIN T. ROSS
  • NPI Number: 1821191396
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2203197
LAB Type Pharmacy
Facility Name FOREST HEIGHTS PHARMACY
Street 4439 COUNTRY CLUB ROAD
City STATESBORO
State GA
ZIP 30458
Phone 912 489-7979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Pharmacy
Lab Director BENJAMIN T. ROSS

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