45D2011771 CLIA NUMBER - WALGREENS #04761

Laboratory Demographics

  • CLIA Code: 45D2011771
  • Facility Name: WALGREENS #04761
  • Facility Address: 6200 W WILLIAM CANNON DR
    AUSTIN, TX
    ZIP 78749
  • Facility Phone: 512 892-1933
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS MCMILLAN
  • NPI Number: 1336154335
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2011771
LAB Type Pharmacy
Facility Name WALGREENS #04761
Street 6200 W WILLIAM CANNON DR
City AUSTIN
State TX
ZIP 78749
Phone 512 892-1933
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Pharmacy
Lab Director CHRIS MCMILLAN

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This page was last updated on: 3/20/2025