11D2287632 CLIA NUMBER - WALGREENS 19428

Laboratory Demographics

  • CLIA Code: 11D2287632
  • Facility Name: WALGREENS 19428
  • Facility Address: 13387 JONES STREET
    LAVONIA, GA
    ZIP 30553
  • Facility Phone: 706 356-4153
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTHONY SHROPSHIRE
  • NPI Number: 1659895142
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2287632
LAB Type Pharmacy
Facility Name WALGREENS 19428
Street 13387 JONES STREET
City LAVONIA
State GA
ZIP 30553
Phone 706 356-4153
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Pharmacy
Lab Director ANTHONY SHROPSHIRE

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