11D2034223 CLIA NUMBER - WALGREENS #7958

Laboratory Demographics

  • CLIA Code: 11D2034223
  • Facility Name: WALGREENS #7958
  • Facility Address: 2630 BRASELTON HIGHWAY, NE
    BUFORD, GA
    ZIP 30519
  • Facility Phone: 678 546-7328
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NORA NANTEZA-MUKASA
  • NPI Number: 1952316069
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034223
LAB Type Pharmacy
Facility Name WALGREENS #7958
Street 2630 BRASELTON HIGHWAY, NE
City BUFORD
State GA
ZIP 30519
Phone 678 546-7328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director NORA NANTEZA-MUKASA

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