11D2034242 CLIA NUMBER - WALGREENS 09981

Laboratory Demographics

  • CLIA Code: 11D2034242
  • Facility Name: WALGREENS 09981
  • Facility Address: 101 PROMINENCE POINT PARKWAY
    CANTON, GA
    ZIP 30114
  • Facility Phone: 770 704-4045
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENDALL J. LOONEY
  • NPI Number: 1518158302
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034242
LAB Type Pharmacy
Facility Name WALGREENS 09981
Street 101 PROMINENCE POINT PARKWAY
City CANTON
State GA
ZIP 30114
Phone 770 704-4045
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 KENDALL J. LOONEY

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