34D2012981 CLIA NUMBER - WALGREENS #05761

Laboratory Demographics

  • CLIA Code: 34D2012981
  • Facility Name: WALGREENS #05761
  • Facility Address: 4701 SOUTH BLVD
    CHARLOTTE, NC
    ZIP 28217
  • Facility Phone: 704 523-3227
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STACY C. HOLBROOK
  • NPI Number: 1558376657
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2012981
LAB Type Pharmacy
Facility Name WALGREENS #05761
Street 4701 SOUTH BLVD
City CHARLOTTE
State NC
ZIP 28217
Phone 704 523-3227
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2025
Certificate Expiration Date 9/25/2027
Facility Type Pharmacy
Lab Director STACY C. HOLBROOK

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