11D2028696 CLIA NUMBER - WALGREENS #07394

Laboratory Demographics

  • CLIA Code: 11D2028696
  • Facility Name: WALGREENS #07394
  • Facility Address: 3740 CASCADE ROAD, SW
    ATLANTA, GA
    ZIP 30331
  • Facility Phone: 404 472-1949
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JARRYN G. SMITH
  • NPI Number: 1326053430
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2028696
LAB Type Pharmacy
Facility Name WALGREENS #07394
Street 3740 CASCADE ROAD, SW
City ATLANTA
State GA
ZIP 30331
Phone 404 472-1949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Pharmacy
Lab Director JARRYN G. SMITH

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