11D2052136 CLIA NUMBER - WALGREENS #12554

Laboratory Demographics

  • CLIA Code: 11D2052136
  • Facility Name: WALGREENS #12554
  • Facility Address: 100 S PEACHTREE PKWY
    PEACHTREE CITY, GA
    ZIP 30269
  • Facility Phone: 770 487-4307
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HANNAH GRAY
  • NPI Number: 1750659421
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2052136
LAB Type Pharmacy
Facility Name WALGREENS #12554
Street 100 S PEACHTREE PKWY
City PEACHTREE CITY
State GA
ZIP 30269
Phone 770 487-4307
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Pharmacy
Lab Director HANNAH GRAY

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