34D2266351 CLIA NUMBER - BRYONALLEN PHARMACY LLC DBA SOUTHSIDE PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2266351
  • Facility Name: BRYONALLEN PHARMACY LLC DBA SOUTHSIDE PHARMACY
  • Facility Address: 98 DODD ST
    SPRING HOPE, NC
    ZIP 27882
  • Facility Phone: 252 478-5969
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRYON M. CLONINGER
  • NPI Number: 1750054532
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2266351
LAB Type Pharmacy
Facility Name BRYONALLEN PHARMACY LLC DBA SOUTHSIDE PHARMACY
Street 98 DODD ST
City SPRING HOPE
State NC
ZIP 27882
Phone 252 478-5969
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Pharmacy
Lab Director BRYON M. CLONINGER

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