34D2193288 CLIA NUMBER - WALGREENS #09191

Laboratory Demographics

  • CLIA Code: 34D2193288
  • Facility Name: WALGREENS #09191
  • Facility Address: 4996 COUNTRY CLUB ROAD
    WINSTON SALEM, NC
    ZIP 27104
  • Facility Phone: 336 774-8420
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: ALAN M. LYALL
  • NPI Number: 1740295831
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2193288
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #09191
Street 4996 COUNTRY CLUB ROAD
City WINSTON SALEM
State NC
ZIP 27104
Phone 336 774-8420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director ALAN M. LYALL

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