11D2034555 CLIA NUMBER - WALGREENS #07068

Laboratory Demographics

  • CLIA Code: 11D2034555
  • Facility Name: WALGREENS #07068
  • Facility Address: 4075 CHEROKEE STREET, NW
    KENNESAW, GA
    ZIP 30144
  • Facility Phone: 770 528-5651
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DALIA H. EID
  • NPI Number: 1598770604
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034555
LAB Type Pharmacy
Facility Name WALGREENS #07068
Street 4075 CHEROKEE STREET, NW
City KENNESAW
State GA
ZIP 30144
Phone 770 528-5651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director DALIA H. EID

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