11D2034348 CLIA NUMBER - WALGREENS 09271

Laboratory Demographics

  • CLIA Code: 11D2034348
  • Facility Name: WALGREENS 09271
  • Facility Address: 7935 TARA BLVD
    JONESBORO, GA
    ZIP 30236
  • Facility Phone: 678 479-1976
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VINCENT O. AJUZIE
  • NPI Number: 1043734684
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034348
LAB Type Pharmacy
Facility Name WALGREENS 09271
Street 7935 TARA BLVD
City JONESBORO
State GA
ZIP 30236
Phone 678 479-1976
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director VINCENT O. AJUZIE

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