34D2003425 CLIA NUMBER - WALGREENS # 12730

Laboratory Demographics

  • CLIA Code: 34D2003425
  • Facility Name: WALGREENS # 12730
  • Facility Address: 11201 DURANT ROAD
    RALEIGH, NC
    ZIP 27614
  • Facility Phone: 919 518-0514
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AJAY S. DESHDANDE
  • NPI Number: 1679806731
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2003425
LAB Type Pharmacy
Facility Name WALGREENS # 12730
Street 11201 DURANT ROAD
City RALEIGH
State NC
ZIP 27614
Phone 919 518-0514
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director AJAY S. DESHDANDE

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