45D2012689 CLIA NUMBER - WALGREENS #06390

Laboratory Demographics

  • CLIA Code: 45D2012689
  • Facility Name: WALGREENS #06390
  • Facility Address: 1015 N TOWN EAST BLVD
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: 972 686-8913
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FUNWIE CALVIN NCHIBNJONQ
  • NPI Number: 1194732073
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2012689
LAB Type Pharmacy
Facility Name WALGREENS #06390
Street 1015 N TOWN EAST BLVD
City MESQUITE
State TX
ZIP 75150
Phone 972 686-8913
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director FUNWIE CALVIN NCHIBNJONQ

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