45D2011776 CLIA NUMBER - WALGREENS #04458

Laboratory Demographics

  • CLIA Code: 45D2011776
  • Facility Name: WALGREENS #04458
  • Facility Address: 3601 W WILLIAM CANNON DR
    AUSTIN, TX
    ZIP 78749
  • Facility Phone: 512 892-0930
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER R. MCMILLAN
  • NPI Number: 1336154335
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2011776
LAB Type Pharmacy
Facility Name WALGREENS #04458
Street 3601 W WILLIAM CANNON DR
City AUSTIN
State TX
ZIP 78749
Phone 512 892-0930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Pharmacy
Lab Director CHRISTOPHER R. MCMILLAN

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