11D2242523 CLIA NUMBER - WALGREENS #17562

Laboratory Demographics

  • CLIA Code: 11D2242523
  • Facility Name: WALGREENS #17562
  • Facility Address: 910 SOUTH WALL STREET
    CALHOUN, GA
    ZIP 30701
  • Facility Phone: 706 602-8008
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HOLLIE TAYLOR
  • NPI Number: 1407379217
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2242523
LAB Type Pharmacy
Facility Name WALGREENS #17562
Street 910 SOUTH WALL STREET
City CALHOUN
State GA
ZIP 30701
Phone 706 602-8008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Pharmacy
Lab Director HOLLIE TAYLOR

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