34D2239204 CLIA NUMBER - WALGREENS #17618

Laboratory Demographics

  • CLIA Code: 34D2239204
  • Facility Name: WALGREENS #17618
  • Facility Address: 995 BETHANIA RURAL HALL ROAD
    RURAL HALL, NC
    ZIP 27045
  • Facility Phone: 336 969-9153
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VICTOR MUKUNGU
  • NPI Number: 1265951180
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2239204
LAB Type Pharmacy
Facility Name WALGREENS #17618
Street 995 BETHANIA RURAL HALL ROAD
City RURAL HALL
State NC
ZIP 27045
Phone 336 969-9153
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2025
Certificate Expiration Date 10/10/2027
Facility Type Pharmacy
Lab Director VICTOR MUKUNGU

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