11D2216562 CLIA NUMBER - BALDWIN PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 11D2216562
  • Facility Name: BALDWIN PHARMACY, LLC
  • Facility Address: 1667 WILLINGHAM AVENUE
    BALDWIN, GA
    ZIP 30511
  • Facility Phone: 706 778-7174
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: C RYAN GURLEY
  • NPI Number: 1194182709
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2216562
LAB Type Pharmacy
Facility Name BALDWIN PHARMACY, LLC
Street 1667 WILLINGHAM AVENUE
City BALDWIN
State GA
ZIP 30511
Phone 706 778-7174
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director C RYAN GURLEY

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