11D2022798 CLIA NUMBER - WALGREENS #09623

Laboratory Demographics

  • CLIA Code: 11D2022798
  • Facility Name: WALGREENS #09623
  • Facility Address: 896 HIGHWAY 81 E
    MCDONOUGH, GA
    ZIP 30252
  • Facility Phone: 770 914-7748
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DESHELL M. BROWN
  • NPI Number: 1770753329
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2022798
LAB Type Pharmacy
Facility Name WALGREENS #09623
Street 896 HIGHWAY 81 E
City MCDONOUGH
State GA
ZIP 30252
Phone 770 914-7748
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Pharmacy
Lab Director DESHELL M. BROWN

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