11D2028707 CLIA NUMBER - WALGREENS #6204

Laboratory Demographics

  • CLIA Code: 11D2028707
  • Facility Name: WALGREENS #6204
  • Facility Address: 7530 ROSWELL ROAD
    ATLANTA, GA
    ZIP 30350
  • Facility Phone: 678 731-9235
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBASHISH ROY
  • NPI Number: 1033124243
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2028707
LAB Type Pharmacy
Facility Name WALGREENS #6204
Street 7530 ROSWELL ROAD
City ATLANTA
State GA
ZIP 30350
Phone 678 731-9235
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director DEBASHISH ROY

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