45D2012678 CLIA NUMBER - WALGREENS #04099

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Laboratory Demographics

CLIA Number: 45D2012678

Facility Name: WALGREENS #04099

Facility Address:
4208 SW GREEN OAKS BLVD
ARLINGTON, TX
ZIP 76017
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Facility Phone Number: 817 483-8368

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1396750345

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType	4
CertificateEffectiveDate	5/21/2023
CertificateExpirationDate	5/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024