49D2054381 CLIA NUMBER - WALGREENS #11525

Laboratory Demographics

  • CLIA Code: 49D2054381
  • Facility Name: WALGREENS #11525
  • Facility Address: 9372 RICHMOND HIGHWAY
    LORTON, VA
    ZIP 22079
  • Facility Phone: 571 642-0103
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIANA C. LE
  • NPI Number: 1053661876
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2054381
LAB Type Pharmacy
Facility Name WALGREENS #11525
Street 9372 RICHMOND HIGHWAY
City LORTON
State VA
ZIP 22079
Phone 571 642-0103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Pharmacy
Lab Director DIANA C. LE

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