11D2229521 CLIA NUMBER - WALGREENS #19839

Laboratory Demographics

  • CLIA Code: 11D2229521
  • Facility Name: WALGREENS #19839
  • Facility Address: 650 E WASHINGTON AVENUE
    ASHBURN, GA
    ZIP 31714
  • Facility Phone: 229 567-3007
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL MILLER
  • NPI Number: 1699290999
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2229521
LAB Type Pharmacy
Facility Name WALGREENS #19839
Street 650 E WASHINGTON AVENUE
City ASHBURN
State GA
ZIP 31714
Phone 229 567-3007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director MICHAEL MILLER

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