45D2012678 CLIA NUMBER - WALGREENS #04099

Laboratory Demographics

  • CLIA Code: 45D2012678
  • Facility Name: WALGREENS #04099
  • Facility Address: 4208 SW GREEN OAKS BLVD
    ARLINGTON, TX
    ZIP 76017
  • Facility Phone: 817 483-8368
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BAI HAN
  • NPI Number: 1396750345
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2012678
LAB Type Pharmacy
Facility Name WALGREENS #04099
Street 4208 SW GREEN OAKS BLVD
City ARLINGTON
State TX
ZIP 76017
Phone 817 483-8368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director BAI HAN

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