11D2229419 CLIA NUMBER - WALGREENS #19997

Laboratory Demographics

  • CLIA Code: 11D2229419
  • Facility Name: WALGREENS #19997
  • Facility Address: 4242 SECOND STREET, N
    FOLKSTON, GA
    ZIP 31537
  • Facility Phone: 912 496-7759
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UCHENNA N. UKOHA
  • NPI Number: 1467976894
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2229419
LAB Type Pharmacy
Facility Name WALGREENS #19997
Street 4242 SECOND STREET, N
City FOLKSTON
State GA
ZIP 31537
Phone 912 496-7759
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2025
Certificate Expiration Date 7/11/2027
Facility Type Pharmacy
Lab Director UCHENNA N. UKOHA

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