34D2290455 CLIA NUMBER - WALGREENS 17798

Laboratory Demographics

  • CLIA Code: 34D2290455
  • Facility Name: WALGREENS 17798
  • Facility Address: 3520 WADE AVENUE
    RALEIGH, NC
    ZIP 27607
  • Facility Phone: 919 832-3749
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MUKUR GUPTA
  • NPI Number: 1932628864
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2290455
LAB Type Pharmacy
Facility Name WALGREENS 17798
Street 3520 WADE AVENUE
City RALEIGH
State NC
ZIP 27607
Phone 919 832-3749
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2023
Certificate Expiration Date 9/25/2025
Facility Type Pharmacy
Lab Director MUKUR GUPTA

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This page was last updated on: 3/20/2025