34D2015584 CLIA NUMBER - WALGREENS #04871

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Laboratory Demographics

CLIA Number: 34D2015584

Facility Name: WALGREENS #04871

Facility Address:
1310 SOUTH CANNON BLVD
KANNAPOLIS, NC
ZIP 28083
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Facility Phone Number: 704 938-7021

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1649285743

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType	4
CertificateEffectiveDate	5/29/2023
CertificateExpirationDate	5/28/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024