51D2043759 CLIA NUMBER - WALGREENS # 11750

Laboratory Demographics

  • CLIA Code: 51D2043759
  • Facility Name: WALGREENS # 11750
  • Facility Address: 101 GOFF MOUNTAIN ROAD
    CROSS LANES, WV
    ZIP 25313
  • Facility Phone: 304 769-0590
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOEY LAFFERTY
  • NPI Number: 1902035454
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2043759
LAB Type Pharmacy
Facility Name WALGREENS # 11750
Street 101 GOFF MOUNTAIN ROAD
City CROSS LANES
State WV
ZIP 25313
Phone 304 769-0590
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Pharmacy
Lab Director JOEY LAFFERTY

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