49D2045563 CLIA NUMBER - WALGREENS #12017

Laboratory Demographics

  • CLIA Code: 49D2045563
  • Facility Name: WALGREENS #12017
  • Facility Address: 3590 VIRGINIA AVENUE
    COLLINSVILLE, VA
    ZIP 24078
  • Facility Phone: 276 647-1101
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY DANIELS
  • NPI Number: 1184890394
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2045563
LAB Type Pharmacy
Facility Name WALGREENS #12017
Street 3590 VIRGINIA AVENUE
City COLLINSVILLE
State VA
ZIP 24078
Phone 276 647-1101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Pharmacy
Lab Director CASEY DANIELS

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