49D2040052 CLIA NUMBER - WALGREENS #12800

Laboratory Demographics

  • CLIA Code: 49D2040052
  • Facility Name: WALGREENS #12800
  • Facility Address: 8414 OLD KEENE MILL ROAD - UNIT A
    SPRINGFIELD, VA
    ZIP 22152
  • Facility Phone: 703 913-6712
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRYSTAL L. UTTER
  • NPI Number: 1225267693
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2040052
LAB Type Pharmacy
Facility Name WALGREENS #12800
Street 8414 OLD KEENE MILL ROAD - UNIT A
City SPRINGFIELD
State VA
ZIP 22152
Phone 703 913-6712
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Pharmacy
Lab Director CRYSTAL L. UTTER

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