11D2288950 CLIA NUMBER - WALGREENS 12464

Laboratory Demographics

  • CLIA Code: 11D2288950
  • Facility Name: WALGREENS 12464
  • Facility Address: 355 HIGHWAY 441 S
    CLAYTON, GA
    ZIP 30525
  • Facility Phone: 706 212-0581
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOLLY E. KEATON-LEDFORD
  • NPI Number: 1144454273
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2288950
LAB Type Pharmacy
Facility Name WALGREENS 12464
Street 355 HIGHWAY 441 S
City CLAYTON
State GA
ZIP 30525
Phone 706 212-0581
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Pharmacy
Lab Director MOLLY E. KEATON-LEDFORD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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