45D2012682 CLIA NUMBER - WALGREENS #03822

Laboratory Demographics

  • CLIA Code: 45D2012682
  • Facility Name: WALGREENS #03822
  • Facility Address: 401 N GALLOWAY AVE
    MESQUITE, TX
    ZIP 75149
  • Facility Phone: 972 329-7440
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN THOMAS
  • NPI Number: 1659388536
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2012682
LAB Type Pharmacy
Facility Name WALGREENS #03822
Street 401 N GALLOWAY AVE
City MESQUITE
State TX
ZIP 75149
Phone 972 329-7440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director JUSTIN THOMAS

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