34D1066009 CLIA NUMBER - FALLS RIVER PHARMACY

Laboratory Demographics

  • CLIA Code: 34D1066009
  • Facility Name: FALLS RIVER PHARMACY
  • Facility Address: 10930 RAVEN RIDGE ROAD STE 109
    RALEIGH, NC
    ZIP 27614
  • Facility Phone: 919 844-2055
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRAVIS P. HOLSHOUSER
  • NPI Number: 1164677852
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D1066009
LAB Type Pharmacy
Facility Name FALLS RIVER PHARMACY
Street 10930 RAVEN RIDGE ROAD STE 109
City RALEIGH
State NC
ZIP 27614
Phone 919 844-2055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Pharmacy
Lab Director TRAVIS P. HOLSHOUSER

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