11D2034173 CLIA NUMBER - WALGREENS #05897

Laboratory Demographics

  • CLIA Code: 11D2034173
  • Facility Name: WALGREENS #05897
  • Facility Address: 1070 RICHARD D SAILORS PARKWAY
    POWDER SPRINGS, GA
    ZIP 30127
  • Facility Phone: 770 222-2897
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMMY WELASHEY
  • NPI Number: 1740295948
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034173
LAB Type Pharmacy
Facility Name WALGREENS #05897
Street 1070 RICHARD D SAILORS PARKWAY
City POWDER SPRINGS
State GA
ZIP 30127
Phone 770 222-2897
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director SAMMY WELASHEY

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