11D2217458 CLIA NUMBER - WALGREENS #10831

Laboratory Demographics

  • CLIA Code: 11D2217458
  • Facility Name: WALGREENS #10831
  • Facility Address: 1410 EAST SHOTWELL STREET
    BAINBRIDGE, GA
    ZIP 39819
  • Facility Phone: 229 246-1441
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAVANNAH L. TINSLEY
  • NPI Number: 1588859888
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2217458
LAB Type Pharmacy
Facility Name WALGREENS #10831
Street 1410 EAST SHOTWELL STREET
City BAINBRIDGE
State GA
ZIP 39819
Phone 229 246-1441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director SAVANNAH L. TINSLEY

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