11D2034243 CLIA NUMBER - WALGREENS 05605

Laboratory Demographics

  • CLIA Code: 11D2034243
  • Facility Name: WALGREENS 05605
  • Facility Address: 695 W CROSSVILE ROAD
    ROSWELL, GA
    ZIP 30075
  • Facility Phone: 770 650-6692
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LIAO BING
  • NPI Number: 1114932316
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034243
LAB Type Pharmacy
Facility Name WALGREENS 05605
Street 695 W CROSSVILE ROAD
City ROSWELL
State GA
ZIP 30075
Phone 770 650-6692
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 LIAO BING

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