49D2014574 CLIA NUMBER - WALGREENS #07644

Laboratory Demographics

  • CLIA Code: 49D2014574
  • Facility Name: WALGREENS #07644
  • Facility Address: 810 W 21ST STREET
    NORFOLK, VA
    ZIP 23517
  • Facility Phone: 757 623-7213
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW BRUINSMA
  • NPI Number: 1639184682
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2014574
LAB Type Pharmacy
Facility Name WALGREENS #07644
Street 810 W 21ST STREET
City NORFOLK
State VA
ZIP 23517
Phone 757 623-7213
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director ANDREW BRUINSMA

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