49D2220277 CLIA NUMBER - WALGREENS #03852

Laboratory Demographics

  • CLIA Code: 49D2220277
  • Facility Name: WALGREENS #03852
  • Facility Address: 1157 AZALEA AVE
    RICHMOND, VA
    ZIP 23227
  • Facility Phone: 804 261-4734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEFALI T. TEKLEMARIAM
  • NPI Number: 1649285685
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2220277
LAB Type Pharmacy
Facility Name WALGREENS #03852
Street 1157 AZALEA AVE
City RICHMOND
State VA
ZIP 23227
Phone 804 261-4734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2023
Certificate Expiration Date 4/11/2025
Facility Type Pharmacy
Lab Director KEFALI T. TEKLEMARIAM

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This page was last updated on: 3/20/2025