34D2041647 CLIA NUMBER - WALGREEN #11504

Laboratory Demographics

  • CLIA Code: 34D2041647
  • Facility Name: WALGREEN #11504
  • Facility Address: 6821 OLD JENKS RD
    APEX, NC
    ZIP 27523
  • Facility Phone: (919) 387-0190
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA L. OSBUN
  • NPI Number: 1588944748
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2041647
LAB Type Pharmacy
Facility Name WALGREEN #11504
Street 6821 OLD JENKS RD
City APEX
State NC
ZIP 27523
Phone 9193870190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2025
Certificate Expiration Date 11/23/2027
Facility Type Pharmacy
Lab Director ANDREA L. OSBUN

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This page was last updated on: 5/18/2026