34D2015584 CLIA NUMBER - WALGREENS #04871

Laboratory Demographics

  • CLIA Code: 34D2015584
  • Facility Name: WALGREENS #04871
  • Facility Address: 1310 SOUTH CANNON BLVD
    KANNAPOLIS, NC
    ZIP 28083
  • Facility Phone: 704 938-7021
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATALIE B. JARVIS
  • NPI Number: 1649285743
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2015584
LAB Type Pharmacy
Facility Name WALGREENS #04871
Street 1310 SOUTH CANNON BLVD
City KANNAPOLIS
State NC
ZIP 28083
Phone 704 938-7021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2025
Certificate Expiration Date 5/28/2027
Facility Type Pharmacy
Lab Director NATALIE B. JARVIS

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