34D2011300 CLIA NUMBER - WALGREENS #11202

Laboratory Demographics

  • CLIA Code: 34D2011300
  • Facility Name: WALGREENS #11202
  • Facility Address: 1712 SOUTH STRATFORD ROAD
    WINSTON-SALEM, NC
    ZIP 27103
  • Facility Phone: 336 765-2967
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LOGAN D. DAVIS
  • NPI Number: 1952596868
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2011300
LAB Type Pharmacy
Facility Name WALGREENS #11202
Street 1712 SOUTH STRATFORD ROAD
City WINSTON-SALEM
State NC
ZIP 27103
Phone 336 765-2967
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Pharmacy
Lab Director LOGAN D. DAVIS

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