44D2033569 CLIA NUMBER - WALGREENS #12934

Laboratory Demographics

  • CLIA Code: 44D2033569
  • Facility Name: WALGREENS #12934
  • Facility Address: 2790 E STONE DR
    KINGSPORT, TN
    ZIP 37660
  • Facility Phone: 423 288-9286
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GRETCHEN NANGLE
  • NPI Number: 1114932134
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2033569
LAB Type Pharmacy
Facility Name WALGREENS #12934
Street 2790 E STONE DR
City KINGSPORT
State TN
ZIP 37660
Phone 423 288-9286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Pharmacy
Lab Director GRETCHEN NANGLE

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