11D2033062 CLIA NUMBER - WALGREENS #5580

Laboratory Demographics

  • CLIA Code: 11D2033062
  • Facility Name: WALGREENS #5580
  • Facility Address: 2035 CANDLER ROAD
    DECATUR, GA
    ZIP 30032
  • Facility Phone: 404 284-9912
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA C. HAIRSTON
  • NPI Number: 1972886406
  • Taxonomy: 183500000X - Pharmacist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2033062
LAB Type Pharmacy
Facility Name WALGREENS #5580
Street 2035 CANDLER ROAD
City DECATUR
State GA
ZIP 30032
Phone 404 284-9912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director ANGELA C. HAIRSTON

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