49D2040062 CLIA NUMBER - WALGREENS #11234

Laboratory Demographics

  • CLIA Code: 49D2040062
  • Facility Name: WALGREENS #11234
  • Facility Address: 10671 SUDLEY MANOR DRIVE
    MANASSAS, VA
    ZIP 20109
  • Facility Phone: 703 257-2894
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHUONG ANH VU
  • NPI Number: 1407082043
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2040062
LAB Type Pharmacy
Facility Name WALGREENS #11234
Street 10671 SUDLEY MANOR DRIVE
City MANASSAS
State VA
ZIP 20109
Phone 703 257-2894
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 PHUONG ANH VU

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