45D2012854 CLIA NUMBER - WALGREENS #04822

Laboratory Demographics

  • CLIA Code: 45D2012854
  • Facility Name: WALGREENS #04822
  • Facility Address: 4847 SLIDE RD
    LUBBOCK, TX
    ZIP 79414
  • Facility Phone: 806 792-8267
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMED JALLAD
  • NPI Number: 1134134109
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2012854
LAB Type Pharmacy
Facility Name WALGREENS #04822
Street 4847 SLIDE RD
City LUBBOCK
State TX
ZIP 79414
Phone 806 792-8267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2025
Certificate Expiration Date 4/29/2027
Facility Type Pharmacy
Lab Director AHMED JALLAD

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