49D2054184 CLIA NUMBER - WALGREENS #13989

Laboratory Demographics

  • CLIA Code: 49D2054184
  • Facility Name: WALGREENS #13989
  • Facility Address: 10213 DUMFRIES ROAD
    MANASSAS, VA
    ZIP 20110
  • Facility Phone: 703 330-4574
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YOUNG JU LEE
  • NPI Number: 1780964957
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2054184
LAB Type Pharmacy
Facility Name WALGREENS #13989
Street 10213 DUMFRIES ROAD
City MANASSAS
State VA
ZIP 20110
Phone 703 330-4574
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director YOUNG JU LEE

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