45D2013366 CLIA NUMBER - WALGREENS 04999

Laboratory Demographics

  • CLIA Code: 45D2013366
  • Facility Name: WALGREENS 04999
  • Facility Address: 1570 11TH ST
    HUNTSVILLE, TX
    ZIP 77340
  • Facility Phone: 936 291-6764
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KHA MANH NGUYEN
  • NPI Number: 1538174537
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2013366
LAB Type Pharmacy
Facility Name WALGREENS 04999
Street 1570 11TH ST
City HUNTSVILLE
State TX
ZIP 77340
Phone 936 291-6764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director KHA MANH NGUYEN

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