34D2060471 CLIA NUMBER - WALGREENS #02696

Laboratory Demographics

  • CLIA Code: 34D2060471
  • Facility Name: WALGREENS #02696
  • Facility Address: 951 DAVIE AVE
    STATESVILLE, NC
    ZIP 28677
  • Facility Phone: 704 873-6216
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TOU KHANG
  • NPI Number: 1831104926
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2060471
LAB Type Pharmacy
Facility Name WALGREENS #02696
Street 951 DAVIE AVE
City STATESVILLE
State NC
ZIP 28677
Phone 704 873-6216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Pharmacy
Lab Director TOU KHANG

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