11D2287634 CLIA NUMBER - WALGREENS 17548

Laboratory Demographics

  • CLIA Code: 11D2287634
  • Facility Name: WALGREENS 17548
  • Facility Address: 100 WEST THIRD STREET
    DONALSONVILLE, GA
    ZIP 39845
  • Facility Phone: 229 524-1126
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHTON JESTER
  • NPI Number: 1356864144
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2287634
LAB Type Pharmacy
Facility Name WALGREENS 17548
Street 100 WEST THIRD STREET
City DONALSONVILLE
State GA
ZIP 39845
Phone 229 524-1126
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 ASHTON JESTER

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