11D2028575 CLIA NUMBER - WALGREENS #7742

Laboratory Demographics

  • CLIA Code: 11D2028575
  • Facility Name: WALGREENS #7742
  • Facility Address: 1510 MILSTEAD AVENUE, NE
    CONYERS, GA
    ZIP 30012
  • Facility Phone: 770 647-6508
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: SHAUNA MARKES-WILSON
  • NPI Number: 1235144346
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2028575
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #7742
Street 1510 MILSTEAD AVENUE, NE
City CONYERS
State GA
ZIP 30012
Phone 770 647-6508
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director SHAUNA MARKES-WILSON

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This page was last updated on: 3/20/2025