11D2034248 CLIA NUMBER - WALGREENS #07396

Laboratory Demographics

  • CLIA Code: 11D2034248
  • Facility Name: WALGREENS #07396
  • Facility Address: 6111 HICKORY FLAT HIGHWAY
    CANTON, GA
    ZIP 30115
  • Facility Phone: 770 479-7039
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: S BOYD COLLIER III
  • NPI Number: 1497760508
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034248
LAB Type Pharmacy
Facility Name WALGREENS #07396
Street 6111 HICKORY FLAT HIGHWAY
City CANTON
State GA
ZIP 30115
Phone 770 479-7039
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director S BOYD COLLIER III

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