49D2230937 CLIA NUMBER - WALGREENS #17890

Laboratory Demographics

  • CLIA Code: 49D2230937
  • Facility Name: WALGREENS #17890
  • Facility Address: 3120 POLO PARKWAY
    MIDLOTHIAN, VA
    ZIP 23113
  • Facility Phone: 804 594-3791
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHILIP Z. CERRETO
  • NPI Number: 1609399617
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2230937
LAB Type Pharmacy
Facility Name WALGREENS #17890
Street 3120 POLO PARKWAY
City MIDLOTHIAN
State VA
ZIP 23113
Phone 804 594-3791
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2023
Certificate Expiration Date 7/28/2025
Facility Type Pharmacy
Lab Director PHILIP Z. CERRETO

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