34D2231018 CLIA NUMBER - WALGREENS #16133

Laboratory Demographics

  • CLIA Code: 34D2231018
  • Facility Name: WALGREENS #16133
  • Facility Address: 454 MAIN STREET
    SPARTA, NC
    ZIP 28675
  • Facility Phone: 336 372-2101
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NESTOR VECIANA
  • NPI Number: 1003242686
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2231018
LAB Type Pharmacy
Facility Name WALGREENS #16133
Street 454 MAIN STREET
City SPARTA
State NC
ZIP 28675
Phone 336 372-2101
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 NESTOR VECIANA

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