51D2234001 CLIA NUMBER - WALGREENS #19614

Laboratory Demographics

  • CLIA Code: 51D2234001
  • Facility Name: WALGREENS #19614
  • Facility Address: 2300 GRAND CENTRAL AVENUE
    VIENNA, WV
    ZIP 26105
  • Facility Phone: 304 295-4573
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN SCOTT PAUL
  • NPI Number: 1093234080
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2234001
LAB Type Pharmacy
Facility Name WALGREENS #19614
Street 2300 GRAND CENTRAL AVENUE
City VIENNA
State WV
ZIP 26105
Phone 304 295-4573
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Pharmacy
Lab Director JOHN SCOTT PAUL

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