49D2290729 CLIA NUMBER - WALGREENS 17493

Laboratory Demographics

  • CLIA Code: 49D2290729
  • Facility Name: WALGREENS 17493
  • Facility Address: 665 KING ST
    KEYSVILLE, VA
    ZIP 23947
  • Facility Phone: 434 736-0060
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIALLO KHADIDIATOU
  • NPI Number: 1093238008
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2290729
LAB Type Pharmacy
Facility Name WALGREENS 17493
Street 665 KING ST
City KEYSVILLE
State VA
ZIP 23947
Phone 434 736-0060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2025
Certificate Expiration Date 9/28/2027
Facility Type Pharmacy
Lab Director DIALLO KHADIDIATOU

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