34D2039251 CLIA NUMBER - WALGREEN #13465

Laboratory Demographics

  • CLIA Code: 34D2039251
  • Facility Name: WALGREEN #13465
  • Facility Address: 717 N BROAD ST
    EDENTON, NC
    ZIP 27932
  • Facility Phone: 252 482-0194
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KACEY S. WEATHERLY
  • NPI Number: 1487974234
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2039251
LAB Type Pharmacy
Facility Name WALGREEN #13465
Street 717 N BROAD ST
City EDENTON
State NC
ZIP 27932
Phone 252 482-0194
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director KACEY S. WEATHERLY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025