34D2100740 CLIA NUMBER - HARRIS TEETER #104 PHARMACY ATTN PHARMACIST IN CHARGE

Laboratory Demographics

  • CLIA Code: 34D2100740
  • Facility Name: HARRIS TEETER #104 PHARMACY ATTN PHARMACIST IN CHARGE
  • Facility Address: 4093 DAVIS DR
    MORRISVILLE, NC
    ZIP 27560
  • Facility Phone: 919 380-3385
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: LINDSAY CAPOZZIELLO
  • NPI Number: 1093817025
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2100740
LAB Type Other - RETAIL PHARMACY
Facility Name HARRIS TEETER #104 PHARMACY ATTN PHARMACIST IN CHARGE
Street 4093 DAVIS DR
City MORRISVILLE
State NC
ZIP 27560
Phone 919 380-3385
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2023
Certificate Expiration Date 8/20/2025
Facility Type Other - RETAIL PHARMACY
Lab Director LINDSAY CAPOZZIELLO

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This page was last updated on: 6/4/2025