11D2218500 CLIA NUMBER - WALGREENS #17706

Laboratory Demographics

  • CLIA Code: 11D2218500
  • Facility Name: WALGREENS #17706
  • Facility Address: 3200 NORTH OAK STREET, EXT
    VALDOSTA, GA
    ZIP 31605
  • Facility Phone: (229) 247-2553
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RITESHIKUMAR H. PATEL
  • NPI Number: 1285157974
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2218500
LAB Type Pharmacy
Facility Name WALGREENS #17706
Street 3200 NORTH OAK STREET, EXT
City VALDOSTA
State GA
ZIP 31605
Phone 2292472553
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director RITESHIKUMAR H. PATEL

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This page was last updated on: 5/18/2026