11D2034587 CLIA NUMBER - WALGREENS #10528

Laboratory Demographics

  • CLIA Code: 11D2034587
  • Facility Name: WALGREENS #10528
  • Facility Address: 4519 DALLAS ACWORTH HIGHWAY
    DALLAS, GA
    ZIP 30132
  • Facility Phone: (770) 443-4988
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIMI M. SHAROMI
  • NPI Number: 1639363047
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034587
LAB Type Pharmacy
Facility Name WALGREENS #10528
Street 4519 DALLAS ACWORTH HIGHWAY
City DALLAS
State GA
ZIP 30132
Phone 7704434988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Pharmacy
Lab Director JIMI M. SHAROMI

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This page was last updated on: 5/18/2026