45D2013163 CLIA NUMBER - WALGREENS #04171

Laboratory Demographics

  • CLIA Code: 45D2013163
  • Facility Name: WALGREENS #04171
  • Facility Address: 2050 LONG PRAIRIE RD
    FLOWER MOUND, TX
    ZIP 75022
  • Facility Phone: 972 355-4831
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAS HEY L. KANG
  • NPI Number: 1679890396
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 45D2013163
LAB Type Pharmacy
Facility Name WALGREENS #04171
Street 2050 LONG PRAIRIE RD
City FLOWER MOUND
State TX
ZIP 75022
Phone 972 355-4831
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director DAS HEY L. KANG

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