34D2218205 CLIA NUMBER - WALGREENS #16119

Laboratory Demographics

  • CLIA Code: 34D2218205
  • Facility Name: WALGREENS #16119
  • Facility Address: 503 E 3RD ST
    PEMBROKE, NC
    ZIP 28372
  • Facility Phone: 910 521-3910
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANJIV R. PATEL
  • NPI Number: 1659707222
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2218205
LAB Type Pharmacy
Facility Name WALGREENS #16119
Street 503 E 3RD ST
City PEMBROKE
State NC
ZIP 28372
Phone 910 521-3910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director SANJIV R. PATEL

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