34D2051890 CLIA NUMBER - WALGREEN #11550

Laboratory Demographics

  • CLIA Code: 34D2051890
  • Facility Name: WALGREEN #11550
  • Facility Address: 4501 MARKET ST
    WILMINGTON, NC
    ZIP 28405
  • Facility Phone: 910 799-0448
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAVIN I. BLOOM
  • NPI Number: 1386906014
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2051890
LAB Type Pharmacy
Facility Name WALGREEN #11550
Street 4501 MARKET ST
City WILMINGTON
State NC
ZIP 28405
Phone 910 799-0448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Pharmacy
Lab Director KAVIN I. BLOOM

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