45D2014202 CLIA NUMBER - WALGREENS #05921

Laboratory Demographics

  • CLIA Code: 45D2014202
  • Facility Name: WALGREENS #05921
  • Facility Address: 1050 E HIGHWAY 377
    GRANBURY, TX
    ZIP 76048
  • Facility Phone: 817 578-3120
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN THOMAS
  • NPI Number: 1205841285
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2014202
LAB Type Pharmacy
Facility Name WALGREENS #05921
Street 1050 E HIGHWAY 377
City GRANBURY
State TX
ZIP 76048
Phone 817 578-3120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director JUSTIN THOMAS

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