34D1082528 CLIA NUMBER - CANNON PHARMACY

Laboratory Demographics

  • CLIA Code: 34D1082528
  • Facility Name: CANNON PHARMACY
  • Facility Address: 1706 S CANNON BOULEVARD
    KANNAPOLIS, NC
    ZIP 28083
  • Facility Phone: 704 933-6337
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN L. FREEMAN
  • NPI Number: 1689925299
  • Taxonomy: 1835P0018X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 34D1082528
LAB Type Pharmacy
Facility Name CANNON PHARMACY
Street 1706 S CANNON BOULEVARD
City KANNAPOLIS
State NC
ZIP 28083
Phone 704 933-6337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Pharmacy
Lab Director BRIAN L. FREEMAN

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