11D2224501 CLIA NUMBER - WALGREENS #15333

Laboratory Demographics

  • CLIA Code: 11D2224501
  • Facility Name: WALGREENS #15333
  • Facility Address: 2493 TOBACCO ROAD
    HEPHZIBAH, GA
    ZIP 30815
  • Facility Phone: 706 793-2106
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATELYN V. DAVIDSON
  • NPI Number: 1649692906
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2224501
LAB Type Pharmacy
Facility Name WALGREENS #15333
Street 2493 TOBACCO ROAD
City HEPHZIBAH
State GA
ZIP 30815
Phone 706 793-2106
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Pharmacy
Lab Director KATELYN V. DAVIDSON

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