49D2039987 CLIA NUMBER - WALGREENS #10165

Laboratory Demographics

  • CLIA Code: 49D2039987
  • Facility Name: WALGREENS #10165
  • Facility Address: 603 ELDEN STREET
    HERNDON, VA
    ZIP 20170
  • Facility Phone: 703 796-6482
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE R. NAK
  • NPI Number: 1174719447
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2039987
LAB Type Pharmacy
Facility Name WALGREENS #10165
Street 603 ELDEN STREET
City HERNDON
State VA
ZIP 20170
Phone 703 796-6482
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director NICOLE R. NAK

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