34D2100592 CLIA NUMBER - HARRIS TEETER #129

Laboratory Demographics

  • CLIA Code: 34D2100592
  • Facility Name: HARRIS TEETER #129
  • Facility Address: 6610 OLD MONROE ROAD ATTN PHARMACIST IN CHARGE
    INDIAN TRAIL, NC
    ZIP 28079
  • Facility Phone: 704 289-1193
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: LINDSAY CAPOZZIELLO
  • NPI Number: 1659475085
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2100592
LAB Type Other - RETAIL PHARMACY
Facility Name HARRIS TEETER #129
Street 6610 OLD MONROE ROAD ATTN PHARMACIST IN CHARGE
City INDIAN TRAIL
State NC
ZIP 28079
Phone 704 289-1193
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Other - RETAIL PHARMACY
Lab Director LINDSAY CAPOZZIELLO

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