11D2245225 CLIA NUMBER - BALL GROUND PHARMACY

Laboratory Demographics

  • CLIA Code: 11D2245225
  • Facility Name: BALL GROUND PHARMACY
  • Facility Address: 470 VALLEY STREET, SUITE 100
    BALL GROUND, GA
    ZIP 30107
  • Facility Phone: 770 735-6161
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY RICHARDSON
  • NPI Number: 1013080811
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2245225
LAB Type Pharmacy
Facility Name BALL GROUND PHARMACY
Street 470 VALLEY STREET, SUITE 100
City BALL GROUND
State GA
ZIP 30107
Phone 770 735-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Pharmacy
Lab Director JEFFREY RICHARDSON

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