34D2222467 CLIA NUMBER - WALGREENS #16112

Laboratory Demographics

  • CLIA Code: 34D2222467
  • Facility Name: WALGREENS #16112
  • Facility Address: 722 W INDEPENDENCE BLVD
    MOUNT AIRY, NC
    ZIP 27030
  • Facility Phone: 336 789-9006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID M. GROVE
  • NPI Number: 1295161131
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2222467
LAB Type Pharmacy
Facility Name WALGREENS #16112
Street 722 W INDEPENDENCE BLVD
City MOUNT AIRY
State NC
ZIP 27030
Phone 336 789-9006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Pharmacy
Lab Director DAVID M. GROVE

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