11D2225655 CLIA NUMBER - WALGREENS #17805

Laboratory Demographics

  • CLIA Code: 11D2225655
  • Facility Name: WALGREENS #17805
  • Facility Address: 1850 BARNETT SHOALS ROAD
    ATHENS, GA
    ZIP 30605
  • Facility Phone: 706 549-3820
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTEN OTT
  • NPI Number: 1700309317
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2225655
LAB Type Pharmacy
Facility Name WALGREENS #17805
Street 1850 BARNETT SHOALS ROAD
City ATHENS
State GA
ZIP 30605
Phone 706 549-3820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Pharmacy
Lab Director KRISTEN OTT

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