45D2011766 CLIA NUMBER - WALGREENS #04823

Laboratory Demographics

  • CLIA Code: 45D2011766
  • Facility Name: WALGREENS #04823
  • Facility Address: 901 E PALM VALLEY BLVD
    ROUND ROCK, TX
    ZIP 78664
  • Facility Phone: 512 248-8742
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RUBY J. HO
  • NPI Number: 1215944251
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2011766
LAB Type Pharmacy
Facility Name WALGREENS #04823
Street 901 E PALM VALLEY BLVD
City ROUND ROCK
State TX
ZIP 78664
Phone 512 248-8742
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Pharmacy
Lab Director RUBY J. HO

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