49D2158786 CLIA NUMBER - WALGREENS #05217

Laboratory Demographics

  • CLIA Code: 49D2158786
  • Facility Name: WALGREENS #05217
  • Facility Address: 4841 WILLIAMSON ROAD NW
    ROANOKE, VA
    ZIP 24012
  • Facility Phone: 540 265-8922
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES MAO
  • NPI Number: 1194730143
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2158786
LAB Type Pharmacy
Facility Name WALGREENS #05217
Street 4841 WILLIAMSON ROAD NW
City ROANOKE
State VA
ZIP 24012
Phone 540 265-8922
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2024
Certificate Expiration Date 12/5/2026
Facility Type Pharmacy
Lab Director JAMES MAO

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