34D2239665 CLIA NUMBER - WALGREENS #17863

Laboratory Demographics

  • CLIA Code: 34D2239665
  • Facility Name: WALGREENS #17863
  • Facility Address: 601 E KINGS ST
    KINGS MOUNTAIN, NC
    ZIP 28086
  • Facility Phone: 704 739-9771
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WENDY PATTERSON BENTON
  • NPI Number: 1730606203
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2239665
LAB Type Pharmacy
Facility Name WALGREENS #17863
Street 601 E KINGS ST
City KINGS MOUNTAIN
State NC
ZIP 28086
Phone 704 739-9771
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2023
Certificate Expiration Date 10/12/2025
Facility Type Pharmacy
Lab Director WENDY PATTERSON BENTON

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