34D2042304 CLIA NUMBER - WALGREENS #11892

Laboratory Demographics

  • CLIA Code: 34D2042304
  • Facility Name: WALGREENS #11892
  • Facility Address: 1114 BRAWLEY SCHOOL RD
    MOORESVILLE, NC
    ZIP 28117
  • Facility Phone: 704 696-2583
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL MILLS
  • NPI Number: 1114156510
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2042304
LAB Type Pharmacy
Facility Name WALGREENS #11892
Street 1114 BRAWLEY SCHOOL RD
City MOORESVILLE
State NC
ZIP 28117
Phone 704 696-2583
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2023
Certificate Expiration Date 6/1/2025
Facility Type Pharmacy
Lab Director RACHEL MILLS

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