11D2241035 CLIA NUMBER - WALGREENS #19700

Laboratory Demographics

  • CLIA Code: 11D2241035
  • Facility Name: WALGREENS #19700
  • Facility Address: 100 SOUTH HIGHWAY I 29
    HOGANSVILLE, GA
    ZIP 30230
  • Facility Phone: 706 637-6461
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATHAN HOXSIE
  • NPI Number: 1033633441
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2241035
LAB Type Pharmacy
Facility Name WALGREENS #19700
Street 100 SOUTH HIGHWAY I 29
City HOGANSVILLE
State GA
ZIP 30230
Phone 706 637-6461
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Pharmacy
Lab Director NATHAN HOXSIE

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