45D2012862 CLIA NUMBER - WALGREENS #06715

Laboratory Demographics

  • CLIA Code: 45D2012862
  • Facility Name: WALGREENS #06715
  • Facility Address: 1305 W UNIVERSITY BLVD
    ODESSA, TX
    ZIP 79764
  • Facility Phone: 432 580-0166
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMED JALLAD
  • NPI Number: 1720093735
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2012862
LAB Type Pharmacy
Facility Name WALGREENS #06715
Street 1305 W UNIVERSITY BLVD
City ODESSA
State TX
ZIP 79764
Phone 432 580-0166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director AHMED JALLAD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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