34D2236484 CLIA NUMBER - MITCHELL & JOHNNSON PHARMACY, INC DBA ISLAND PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2236484
  • Facility Name: MITCHELL & JOHNNSON PHARMACY, INC DBA ISLAND PHARMACY
  • Facility Address: 2181-A OLD MOUNTAIN ROAD
    STATESVILLE, NC
    ZIP 28687
  • Facility Phone: 704 873-0000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY K. MITCHELL
  • NPI Number: 1861406118
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2236484
LAB Type Pharmacy
Facility Name MITCHELL & JOHNNSON PHARMACY, INC DBA ISLAND PHARMACY
Street 2181-A OLD MOUNTAIN ROAD
City STATESVILLE
State NC
ZIP 28687
Phone 704 873-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Pharmacy
Lab Director KIMBERLY K. MITCHELL

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