49D2203919 CLIA NUMBER - WALGREENS #19095

Laboratory Demographics

  • CLIA Code: 49D2203919
  • Facility Name: WALGREENS #19095
  • Facility Address: 5261 US HIGHWAY 421
    PENNINGTON GAP, VA
    ZIP 24277
  • Facility Phone: 276 546-4613
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANNON HAYNES
  • NPI Number: 1669995536
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2203919
LAB Type Pharmacy
Facility Name WALGREENS #19095
Street 5261 US HIGHWAY 421
City PENNINGTON GAP
State VA
ZIP 24277
Phone 276 546-4613
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Pharmacy
Lab Director SHANNON HAYNES

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