34D2039240 CLIA NUMBER - WALGREEN #07981

Laboratory Demographics

  • CLIA Code: 34D2039240
  • Facility Name: WALGREEN #07981
  • Facility Address: 1361 N LAKE PARK BLVD
    CAROLINA BEACH, NC
    ZIP 28428
  • Facility Phone: 910 458-4172
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL A. WITTMAN
  • NPI Number: 1578578571
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2039240
LAB Type Pharmacy
Facility Name WALGREEN #07981
Street 1361 N LAKE PARK BLVD
City CAROLINA BEACH
State NC
ZIP 28428
Phone 910 458-4172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Pharmacy
Lab Director DANIEL A. WITTMAN

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