11D2251018 CLIA NUMBER - MAGNOLIA PHARMACY

Laboratory Demographics

CLIA Number: 11D2251018

Facility Name: MAGNOLIA PHARMACY

Facility Address:
4626 BATTLEFIELD PARKWAY
RINGGOLD, GA
ZIP 30736
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Facility Phone Number: 706 841-0444

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1770188849

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	11D2251018
LAB Type	Pharmacy
Facility Name	MAGNOLIA PHARMACY
Street	4626 BATTLEFIELD PARKWAY
City	RINGGOLD
State	GA
ZIP	30736
Phone	706 841-0444
CertificateType	4
CertificateEffectiveDate	1/31/2024
CertificateExpirationDate	1/30/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024