11D2042196 CLIA NUMBER - WALGREENS 10246

Laboratory Demographics

  • CLIA Code: 11D2042196
  • Facility Name: WALGREENS 10246
  • Facility Address: 5864 FAIRBURN ROAD
    DOUGLASVILLE, GA
    ZIP 30134
  • Facility Phone: 770 949-9307
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ALLANA C. THOMPSON
  • NPI Number: 1790702405
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2042196
LAB Type Home Health Agency
Facility Name WALGREENS 10246
Street 5864 FAIRBURN ROAD
City DOUGLASVILLE
State GA
ZIP 30134
Phone 770 949-9307
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Home Health Agency
Lab Director ALLANA C. THOMPSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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