11D2218292 CLIA NUMBER - WALGREENS #19322

Laboratory Demographics

  • CLIA Code: 11D2218292
  • Facility Name: WALGREENS #19322
  • Facility Address: 405 SOUTH HILL STREET
    GRIFFIN, GA
    ZIP 30224
  • Facility Phone: 770 412-6006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAIZA GANDOLA
  • NPI Number: 1861918591
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2218292
LAB Type Pharmacy
Facility Name WALGREENS #19322
Street 405 SOUTH HILL STREET
City GRIFFIN
State GA
ZIP 30224
Phone 770 412-6006
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 RAIZA GANDOLA

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