11D2229530 CLIA NUMBER - WALGREENS #17421

Laboratory Demographics

  • CLIA Code: 11D2229530
  • Facility Name: WALGREENS #17421
  • Facility Address: 305 WEST OGEECHEE STREET
    SYLVANIA, GA
    ZIP 30467
  • Facility Phone: 912 564-2668
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UMANG B. PATEL
  • NPI Number: 1508380148
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2229530
LAB Type Pharmacy
Facility Name WALGREENS #17421
Street 305 WEST OGEECHEE STREET
City SYLVANIA
State GA
ZIP 30467
Phone 912 564-2668
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 UMANG B. PATEL

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