34D2011308 CLIA NUMBER - WALGREENS #07397

Laboratory Demographics

  • CLIA Code: 34D2011308
  • Facility Name: WALGREENS #07397
  • Facility Address: 2125 CLOVERDALE AVE
    WINSTON-SALEM, NC
    ZIP 27103
  • Facility Phone: 336 723-0561
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN S. GRAHAM
  • NPI Number: 1912912098
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2011308
LAB Type Pharmacy
Facility Name WALGREENS #07397
Street 2125 CLOVERDALE AVE
City WINSTON-SALEM
State NC
ZIP 27103
Phone 336 723-0561
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2025
Certificate Expiration Date 10/12/2027
Facility Type Pharmacy
Lab Director JONATHAN S. GRAHAM

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