45D2013147 CLIA NUMBER - WALGREENS #04692

Laboratory Demographics

  • CLIA Code: 45D2013147
  • Facility Name: WALGREENS #04692
  • Facility Address: 6984 RUFE SNOW DR
    FORT WORTH, TX
    ZIP 76148
  • Facility Phone: 817 427-9353
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MINH NGUYEN
  • NPI Number: 1851307292
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2013147
LAB Type Pharmacy
Facility Name WALGREENS #04692
Street 6984 RUFE SNOW DR
City FORT WORTH
State TX
ZIP 76148
Phone 817 427-9353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director MINH NGUYEN

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