11D2209594 CLIA NUMBER - CRAWFORD AND BREAZEALE DRUG COMPANY

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Laboratory Demographics

CLIA Number: 11D2209594

Facility Name: CRAWFORD AND BREAZEALE DRUG COMPANY

Facility Address:
125 NORTH WASHINGTON STREET
LINCOLNTON, GA
ZIP 30817
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Facility Phone Number: 706 359-3343

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1306929468

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	11D2209594
LAB Type	Pharmacy
Facility Name	CRAWFORD AND BREAZEALE DRUG COMPANY
Street	125 NORTH WASHINGTON STREET
City	LINCOLNTON
State	GA
ZIP	30817
Phone	706 359-3343
CertificateType	4
CertificateEffectiveDate	1/14/2023
CertificateExpirationDate	1/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024