34D2012903 CLIA NUMBER - WALGREENS #07748

Laboratory Demographics

  • CLIA Code: 34D2012903
  • Facility Name: WALGREENS #07748
  • Facility Address: 359 WESTERN BLVD
    JACKSONVILLE, NC
    ZIP 28546
  • Facility Phone: 910 355-7056
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NELINA D. HOME
  • NPI Number: 1922013929
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2012903
LAB Type Pharmacy
Facility Name WALGREENS #07748
Street 359 WESTERN BLVD
City JACKSONVILLE
State NC
ZIP 28546
Phone 910 355-7056
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 NELINA D. HOME

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