11D2034170 CLIA NUMBER - WALGREENS 09155

Laboratory Demographics

  • CLIA Code: 11D2034170
  • Facility Name: WALGREENS 09155
  • Facility Address: 3414 MUNDY MILL ROAD
    GAINESVILLE, GA
    ZIP 30507
  • Facility Phone: 770 287-8359
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KOFI A. BAWUAH
  • NPI Number: 1689689796
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034170
LAB Type Pharmacy
Facility Name WALGREENS 09155
Street 3414 MUNDY MILL ROAD
City GAINESVILLE
State GA
ZIP 30507
Phone 770 287-8359
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Pharmacy
Lab Director KOFI A. BAWUAH

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