34D2230946 CLIA NUMBER - WALGREENS #17018

Laboratory Demographics

  • CLIA Code: 34D2230946
  • Facility Name: WALGREENS #17018
  • Facility Address: 5016 OLD TAR ROAD
    WINTERVILLE, NC
    ZIP 28590
  • Facility Phone: 252 321-0649
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. RAKESH N. PATEL
  • NPI Number: 1902322050
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2230946
LAB Type Pharmacy
Facility Name WALGREENS #17018
Street 5016 OLD TAR ROAD
City WINTERVILLE
State NC
ZIP 28590
Phone 252 321-0649
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Pharmacy
Lab Director MR. RAKESH N. PATEL

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