45D2013741 CLIA NUMBER - WALGREENS #10583

Laboratory Demographics

  • CLIA Code: 45D2013741
  • Facility Name: WALGREENS #10583
  • Facility Address: 3103 PALMER HWY
    TEXAS CITY, TX
    ZIP 77590
  • Facility Phone: 409 945-0702
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THEOPHILUS R. FALLS
  • NPI Number: 1639184641
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2013741
LAB Type Pharmacy
Facility Name WALGREENS #10583
Street 3103 PALMER HWY
City TEXAS CITY
State TX
ZIP 77590
Phone 409 945-0702
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director THEOPHILUS R. FALLS

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