34D2062708 CLIA NUMBER - WALGREENS #12077

Laboratory Demographics

  • CLIA Code: 34D2062708
  • Facility Name: WALGREENS #12077
  • Facility Address: 11801 VOGEL STREET
    RALEIGH, NC
    ZIP 27617
  • Facility Phone: 919 544-1387
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID ANDREW STICKLEY
  • NPI Number: 1548543762
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2062708
LAB Type Pharmacy
Facility Name WALGREENS #12077
Street 11801 VOGEL STREET
City RALEIGH
State NC
ZIP 27617
Phone 919 544-1387
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2023
Certificate Expiration Date 8/9/2025
Facility Type Pharmacy
Lab Director DAVID ANDREW STICKLEY

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This page was last updated on: 6/4/2025