11D2034607 CLIA NUMBER - WALGREENS 05954

Laboratory Demographics

  • CLIA Code: 11D2034607
  • Facility Name: WALGREENS 05954
  • Facility Address: 1247 WALNUT AVENUE, WEST
    DALTON, GA
    ZIP 30720
  • Facility Phone: 706 428-9003
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NITA PATEL
  • NPI Number: 1235441494
  • Taxonomy: 305S00000X - Point of Service

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CLIA Record

Field Name Field Value
CLIA Number 11D2034607
LAB Type Pharmacy
Facility Name WALGREENS 05954
Street 1247 WALNUT AVENUE, WEST
City DALTON
State GA
ZIP 30720
Phone 706 428-9003
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 NITA PATEL

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