49D2203921 CLIA NUMBER - WALGREENS #17869

Laboratory Demographics

  • CLIA Code: 49D2203921
  • Facility Name: WALGREENS #17869
  • Facility Address: 121 NORTH MAIN STREET
    PEARISBURG, VA
    ZIP 24134
  • Facility Phone: 304 588-3880
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JARREN T. MCCOWAN
  • NPI Number: 1710400726
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2203921
LAB Type Pharmacy
Facility Name WALGREENS #17869
Street 121 NORTH MAIN STREET
City PEARISBURG
State VA
ZIP 24134
Phone 304 588-3880
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 JARREN T. MCCOWAN

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