11D2034593 CLIA NUMBER - WALGREENS 05990

Laboratory Demographics

  • CLIA Code: 11D2034593
  • Facility Name: WALGREENS 05990
  • Facility Address: 2075 LAWRENCEVILLE SUWANEE ROAD
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 678 377-5258
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIN SUN
  • NPI Number: 1518481175
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034593
LAB Type Pharmacy
Facility Name WALGREENS 05990
Street 2075 LAWRENCEVILLE SUWANEE ROAD
City SUWANEE
State GA
ZIP 30024
Phone 678 377-5258
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Pharmacy
Lab Director JIN SUN

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