34D2101622 CLIA NUMBER - HARRIS TEETER #395

Laboratory Demographics

  • CLIA Code: 34D2101622
  • Facility Name: HARRIS TEETER #395
  • Facility Address: 1432 BRODGEN WOODS DRIVE
    WAKE FOREST, NC
    ZIP 27587
  • Facility Phone: 919 870-4984
  • Facility Type: Other - RETIAL PHARMACY
  • Facility Type: Waiver
  • Lab Director: LINDSAY CAPOZZIELLO
  • NPI Number: 1942649447
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2101622
LAB Type Other - RETIAL PHARMACY
Facility Name HARRIS TEETER #395
Street 1432 BRODGEN WOODS DRIVE
City WAKE FOREST
State NC
ZIP 27587
Phone 919 870-4984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2025
Certificate Expiration Date 9/3/2027
Facility Type Other - RETIAL PHARMACY
Lab Director LINDSAY CAPOZZIELLO

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