11D2034221 CLIA NUMBER - WALGREENS #05898

Laboratory Demographics

  • CLIA Code: 11D2034221
  • Facility Name: WALGREENS #05898
  • Facility Address: 5455 LAWRENCEVILLE HIGHWAY, NW
    LILBURN, GA
    ZIP 30047
  • Facility Phone: 770 981-1351
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN H. LIM
  • NPI Number: 1588679781
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034221
LAB Type Pharmacy
Facility Name WALGREENS #05898
Street 5455 LAWRENCEVILLE HIGHWAY, NW
City LILBURN
State GA
ZIP 30047
Phone 770 981-1351
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Pharmacy
Lab Director JUSTIN H. LIM

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