34D2060469 CLIA NUMBER - WALGREENS #11765

Laboratory Demographics

  • CLIA Code: 34D2060469
  • Facility Name: WALGREENS #11765
  • Facility Address: 1230 E MAIN STREET
    LINCOLNTON, NC
    ZIP 28092
  • Facility Phone: 704 745-0091
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN K. MASON
  • NPI Number: 1275835928
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2060469
LAB Type Pharmacy
Facility Name WALGREENS #11765
Street 1230 E MAIN STREET
City LINCOLNTON
State NC
ZIP 28092
Phone 704 745-0091
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 BRIAN K. MASON

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