11D2308131 CLIA NUMBER - WALGREENS 21594

Laboratory Demographics

  • CLIA Code: 11D2308131
  • Facility Name: WALGREENS 21594
  • Facility Address: 584 LANIER PARK DRIVE
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 470 252-3009
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL R. TILLMAN
  • NPI Number: 1184474405
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2308131
LAB Type Pharmacy
Facility Name WALGREENS 21594
Street 584 LANIER PARK DRIVE
City GAINESVILLE
State GA
ZIP 30501
Phone 470 252-3009
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Pharmacy
Lab Director PAUL R. TILLMAN

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: 6/4/2025