49D2012773 CLIA NUMBER - WALGREENS #5216

Laboratory Demographics

  • CLIA Code: 49D2012773
  • Facility Name: WALGREENS #5216
  • Facility Address: 4049 BRAMBLETON AVENUE
    ROANOKE, VA
    ZIP 24018
  • Facility Phone: 540 725-1545
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC MALEN
  • NPI Number: 1003821059
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2012773
LAB Type Pharmacy
Facility Name WALGREENS #5216
Street 4049 BRAMBLETON AVENUE
City ROANOKE
State VA
ZIP 24018
Phone 540 725-1545
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Pharmacy
Lab Director ERIC MALEN

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