49D2043706 CLIA NUMBER - WALGREENS #9417

Laboratory Demographics

  • CLIA Code: 49D2043706
  • Facility Name: WALGREENS #9417
  • Facility Address: 3489 SEMINOLE TRAIL
    CHARLOTTESVILLE, VA
    ZIP 22911
  • Facility Phone: 434 964-1082
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EVAN A. WHITE
  • NPI Number: 1639333594
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2043706
LAB Type Pharmacy
Facility Name WALGREENS #9417
Street 3489 SEMINOLE TRAIL
City CHARLOTTESVILLE
State VA
ZIP 22911
Phone 434 964-1082
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Pharmacy
Lab Director EVAN A. WHITE

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