11D2042715 CLIA NUMBER - WALGREENS #12502

Laboratory Demographics

  • CLIA Code: 11D2042715
  • Facility Name: WALGREENS #12502
  • Facility Address: 876 BIG A ROAD
    TOCCOA, GA
    ZIP 30577
  • Facility Phone: 706 297-7618
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA W. HENDRIX
  • NPI Number: 1245478346
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2042715
LAB Type Pharmacy
Facility Name WALGREENS #12502
Street 876 BIG A ROAD
City TOCCOA
State GA
ZIP 30577
Phone 706 297-7618
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director CYNTHIA W. HENDRIX

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