11D2065333 CLIA NUMBER - WALGREENS #15180

Laboratory Demographics

  • CLIA Code: 11D2065333
  • Facility Name: WALGREENS #15180
  • Facility Address: 101 N TENNESSEE STREET
    CARTERSVILLE, GA
    ZIP 30120
  • Facility Phone: 770 387-2525
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DUSTIN COMSTOCK
  • NPI Number: 1962840967
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2065333
LAB Type Pharmacy
Facility Name WALGREENS #15180
Street 101 N TENNESSEE STREET
City CARTERSVILLE
State GA
ZIP 30120
Phone 770 387-2525
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 DUSTIN COMSTOCK

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