34D2122082 CLIA NUMBER - SOUTHSIDE DISCOUNT PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2122082
  • Facility Name: SOUTHSIDE DISCOUNT PHARMACY
  • Facility Address: 3085 WAUGHTOWN STREET
    WINSTON-SALEM, NC
    ZIP 27107
  • Facility Phone: 336 830-8774
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHUNNA E. FREEMAN
  • NPI Number: 1134548415
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2122082
LAB Type Pharmacy
Facility Name SOUTHSIDE DISCOUNT PHARMACY
Street 3085 WAUGHTOWN STREET
City WINSTON-SALEM
State NC
ZIP 27107
Phone 336 830-8774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Pharmacy
Lab Director AHUNNA E. FREEMAN

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