45D2013703 CLIA NUMBER - WALGREENS #04113

Laboratory Demographics

  • CLIA Code: 45D2013703
  • Facility Name: WALGREENS #04113
  • Facility Address: 1620 S GORDON ST
    ALVIN, TX
    ZIP 77511
  • Facility Phone: 281 585-2404
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHEN T. ROEDER
  • NPI Number: 1023023090
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2013703
LAB Type Pharmacy
Facility Name WALGREENS #04113
Street 1620 S GORDON ST
City ALVIN
State TX
ZIP 77511
Phone 281 585-2404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Pharmacy
Lab Director STEPHEN T. ROEDER

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