34D2012991 CLIA NUMBER - WALGREENS #07401

Laboratory Demographics

  • CLIA Code: 34D2012991
  • Facility Name: WALGREENS #07401
  • Facility Address: 13720 INDEPENDENCE BOULEVARD
    INDIAN TRAIL, NC
    ZIP 28079
  • Facility Phone: 704 821-1589
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JILL A. MAGDA
  • NPI Number: 1578578670
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2012991
LAB Type Pharmacy
Facility Name WALGREENS #07401
Street 13720 INDEPENDENCE BOULEVARD
City INDIAN TRAIL
State NC
ZIP 28079
Phone 704 821-1589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director JILL A. MAGDA

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