49D2039990 CLIA NUMBER - WALGREENS #11299

Laboratory Demographics

  • CLIA Code: 49D2039990
  • Facility Name: WALGREENS #11299
  • Facility Address: 12601 SMOKETOWN ROAD
    WOODBRIDGE, VA
    ZIP 22192
  • Facility Phone: 703 670-7030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MEKBIB M. BELETE
  • NPI Number: 1184932386
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2039990
LAB Type Pharmacy
Facility Name WALGREENS #11299
Street 12601 SMOKETOWN ROAD
City WOODBRIDGE
State VA
ZIP 22192
Phone 703 670-7030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2023
Certificate Expiration Date 9/24/2025
Facility Type Pharmacy
Lab Director MEKBIB M. BELETE

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