11D2226271 CLIA NUMBER - WALGREENS #19629

Laboratory Demographics

CLIA Number: 11D2226271

Facility Name: WALGREENS #19629

Facility Address:
4600 HABERSHAM STREET
SAVANNAH, GA
ZIP 31405
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Facility Phone Number: 912 354-5083

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1063936391

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	11D2226271
LAB Type	Pharmacy
Facility Name	WALGREENS #19629
Street	4600 HABERSHAM STREET
City	SAVANNAH
State	GA
ZIP	31405
Phone	912 354-5083
CertificateType	4
CertificateEffectiveDate	5/27/2023
CertificateExpirationDate	5/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024