34D2041810 CLIA NUMBER - WALGREENS #11667

Laboratory Demographics

  • CLIA Code: 34D2041810
  • Facility Name: WALGREENS #11667
  • Facility Address: 1590 BENVENUE RD
    ROCKY MOUNT, NC
    ZIP 27804
  • Facility Phone: 252 212-0381
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FATIMA S. HARLESS
  • NPI Number: 1548494628
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2041810
LAB Type Pharmacy
Facility Name WALGREENS #11667
Street 1590 BENVENUE RD
City ROCKY MOUNT
State NC
ZIP 27804
Phone 252 212-0381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director FATIMA S. HARLESS

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