49D2040029 CLIA NUMBER - WALGREENS #13012

Laboratory Demographics

  • CLIA Code: 49D2040029
  • Facility Name: WALGREENS #13012
  • Facility Address: 6400 HOADLY ROAD
    MANASSAS, VA
    ZIP 20112
  • Facility Phone: 703 259-6390
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABIGAIL SARPONG
  • NPI Number: 1134451818
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2040029
LAB Type Pharmacy
Facility Name WALGREENS #13012
Street 6400 HOADLY ROAD
City MANASSAS
State VA
ZIP 20112
Phone 703 259-6390
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Pharmacy
Lab Director ABIGAIL SARPONG

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