11D2041931 CLIA NUMBER - WALGREENS #6209

Laboratory Demographics

  • CLIA Code: 11D2041931
  • Facility Name: WALGREENS #6209
  • Facility Address: 1855 HUDSON BRIDGE ROAD
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 678 565-0648
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CATHY F. TANKOUA
  • NPI Number: 1811904899
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2041931
LAB Type Pharmacy
Facility Name WALGREENS #6209
Street 1855 HUDSON BRIDGE ROAD
City STOCKBRIDGE
State GA
ZIP 30281
Phone 678 565-0648
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director CATHY F. TANKOUA

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