11D2034148 CLIA NUMBER - WALGREENS 10422

Laboratory Demographics

  • CLIA Code: 11D2034148
  • Facility Name: WALGREENS 10422
  • Facility Address: 3658 ROSWELL ROAD, NE
    ATLANTA, GA
    ZIP 30342
  • Facility Phone: 404 816-8464
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MA SHERRIEL R. PADYA
  • NPI Number: 1326176744
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034148
LAB Type Pharmacy
Facility Name WALGREENS 10422
Street 3658 ROSWELL ROAD, NE
City ATLANTA
State GA
ZIP 30342
Phone 404 816-8464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Pharmacy
Lab Director MA SHERRIEL R. PADYA

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