11D2030138 CLIA NUMBER - WALGREENS #06374

Laboratory Demographics

  • CLIA Code: 11D2030138
  • Facility Name: WALGREENS #06374
  • Facility Address: 649 SHALLOWFORD ROAD, NW
    GAINESVILLE, GA
    ZIP 30504
  • Facility Phone: 678 450-8847
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRICIA R. MERRICK
  • NPI Number: 1568477768
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2030138
LAB Type Pharmacy
Facility Name WALGREENS #06374
Street 649 SHALLOWFORD ROAD, NW
City GAINESVILLE
State GA
ZIP 30504
Phone 678 450-8847
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Pharmacy
Lab Director TRICIA R. MERRICK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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