11D2034326 CLIA NUMBER - WALGREENS #06208

Laboratory Demographics

  • CLIA Code: 11D2034326
  • Facility Name: WALGREENS #06208
  • Facility Address: 204 JONESBORO ROAD
    MCDONOUGH, GA
    ZIP 30253
  • Facility Phone: 678 583-5381
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SPENCER P. COWART
  • NPI Number: 1316952526
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034326
LAB Type Pharmacy
Facility Name WALGREENS #06208
Street 204 JONESBORO ROAD
City MCDONOUGH
State GA
ZIP 30253
Phone 678 583-5381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director SPENCER P. COWART

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