45D2014758 CLIA NUMBER - WALGREENS #05377

Laboratory Demographics

  • CLIA Code: 45D2014758
  • Facility Name: WALGREENS #05377
  • Facility Address: 833 S W WILSHIRE BLVD
    BURLESON, TX
    ZIP 76028
  • Facility Phone: 817 447-4172
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FARHAN F. ISLAM
  • NPI Number: 1932114907
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2014758
LAB Type Pharmacy
Facility Name WALGREENS #05377
Street 833 S W WILSHIRE BLVD
City BURLESON
State TX
ZIP 76028
Phone 817 447-4172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Pharmacy
Lab Director FARHAN F. ISLAM

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This page was last updated on: 6/4/2025