49D2087366 CLIA NUMBER - WALGREENS #6790

Laboratory Demographics

  • CLIA Code: 49D2087366
  • Facility Name: WALGREENS #6790
  • Facility Address: 3376 VIRGINIA BEACH BOULEVARD
    VIRGINIA BEACH, VA
    ZIP 23452
  • Facility Phone: 757 340-8013
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES BACCELLIERI
  • NPI Number: 1669489696
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2087366
LAB Type Pharmacy
Facility Name WALGREENS #6790
Street 3376 VIRGINIA BEACH BOULEVARD
City VIRGINIA BEACH
State VA
ZIP 23452
Phone 757 340-8013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Pharmacy
Lab Director JAMES BACCELLIERI

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