11D2028567 CLIA NUMBER - WALGREENS #9706

Laboratory Demographics

  • CLIA Code: 11D2028567
  • Facility Name: WALGREENS #9706
  • Facility Address: 472 S ENOTA DRIVE, NE
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 770 535-3750
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW S. OWENS
  • NPI Number: 1760497879
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2028567
LAB Type Pharmacy
Facility Name WALGREENS #9706
Street 472 S ENOTA DRIVE, NE
City GAINESVILLE
State GA
ZIP 30501
Phone 770 535-3750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2023
Certificate Expiration Date 8/28/2025
Facility Type Pharmacy
Lab Director MATTHEW S. OWENS

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This page was last updated on: 6/4/2025