34D2271224 CLIA NUMBER - LAKESIDE PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2271224
  • Facility Name: LAKESIDE PHARMACY
  • Facility Address: 9615 SHERRILL ESTATES RD, STE B
    HUNTERSVILLE, NC
    ZIP 28078
  • Facility Phone: 980 441-8600
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THANVEER R. GADWAL
  • NPI Number: 1245723725
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2271224
LAB Type Pharmacy
Facility Name LAKESIDE PHARMACY
Street 9615 SHERRILL ESTATES RD, STE B
City HUNTERSVILLE
State NC
ZIP 28078
Phone 980 441-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Pharmacy
Lab Director THANVEER R. GADWAL

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