34D2006827 CLIA NUMBER - CANNON PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2006827
  • Facility Name: CANNON PHARMACY
  • Facility Address: 2334 SOUTH BLVD
    CHARLOTTE, NC
    ZIP 28203
  • Facility Phone: 704 938-5237
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HELEN MAHAIRAS
  • NPI Number: 1396128203
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2006827
LAB Type Pharmacy
Facility Name CANNON PHARMACY
Street 2334 SOUTH BLVD
City CHARLOTTE
State NC
ZIP 28203
Phone 704 938-5237
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Pharmacy
Lab Director HELEN MAHAIRAS

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