11D2042230 CLIA NUMBER - WALGREENS #05485

Laboratory Demographics

  • CLIA Code: 11D2042230
  • Facility Name: WALGREENS #05485
  • Facility Address: 2779 COBB PARKWAY, NW
    KENNESAW, GA
    ZIP 30152
  • Facility Phone: 770 795-1838
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UZOAMAKA OBIEKWE
  • NPI Number: 1851306054
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2042230
LAB Type Pharmacy
Facility Name WALGREENS #05485
Street 2779 COBB PARKWAY, NW
City KENNESAW
State GA
ZIP 30152
Phone 770 795-1838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Pharmacy
Lab Director UZOAMAKA OBIEKWE

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