11D2229561 CLIA NUMBER - WALGREENS #17943

Laboratory Demographics

  • CLIA Code: 11D2229561
  • Facility Name: WALGREENS #17943
  • Facility Address: 363 BLUE RIDGE STREET
    BLAIRSVILLE, GA
    ZIP 30512
  • Facility Phone: 706 745-6954
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GERALD DYER
  • NPI Number: 1447774013
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2229561
LAB Type Pharmacy
Facility Name WALGREENS #17943
Street 363 BLUE RIDGE STREET
City BLAIRSVILLE
State GA
ZIP 30512
Phone 706 745-6954
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Pharmacy
Lab Director GERALD DYER

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