49D2052322 CLIA NUMBER - WALGREENS #5588

Laboratory Demographics

  • CLIA Code: 49D2052322
  • Facility Name: WALGREENS #5588
  • Facility Address: 9976 JEFFERSON AVENUE
    NEWPORT NEWS, VA
    ZIP 23605
  • Facility Phone: 757 599-9626
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAVEN WELLS
  • NPI Number: 1386659332
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2052322
LAB Type Pharmacy
Facility Name WALGREENS #5588
Street 9976 JEFFERSON AVENUE
City NEWPORT NEWS
State VA
ZIP 23605
Phone 757 599-9626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Pharmacy
Lab Director RAVEN WELLS

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