34D2288559 CLIA NUMBER - WALGREENS 17073

Laboratory Demographics

  • CLIA Code: 34D2288559
  • Facility Name: WALGREENS 17073
  • Facility Address: 4133 PARK ROAD
    CHARLOTTE, NC
    ZIP 28209
  • Facility Phone: 704 523-3031
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PARTHIVKUMAR V. PATEL
  • NPI Number: 1467979161
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2288559
LAB Type Pharmacy
Facility Name WALGREENS 17073
Street 4133 PARK ROAD
City CHARLOTTE
State NC
ZIP 28209
Phone 704 523-3031
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Pharmacy
Lab Director PARTHIVKUMAR V. PATEL

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