45D2011768 CLIA NUMBER - WALGREENS #06158

Laboratory Demographics

  • CLIA Code: 45D2011768
  • Facility Name: WALGREENS #06158
  • Facility Address: 3614 S 31ST STREET
    TEMPLE, TX
    ZIP 76502
  • Facility Phone: 254 899-8484
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AIMEE A. LUSSON
  • NPI Number: 1669487658
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2011768
LAB Type Pharmacy
Facility Name WALGREENS #06158
Street 3614 S 31ST STREET
City TEMPLE
State TX
ZIP 76502
Phone 254 899-8484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director AIMEE A. LUSSON

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