45D2015673 CLIA NUMBER - WALGREENS #03141

Laboratory Demographics

  • CLIA Code: 45D2015673
  • Facility Name: WALGREENS #03141
  • Facility Address: 1105 GOLIAD RD
    SAN ANTONIO, TX
    ZIP 78223
  • Facility Phone: 210 533-7602
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN G. EVANS
  • NPI Number: 1942217955
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2015673
LAB Type Pharmacy
Facility Name WALGREENS #03141
Street 1105 GOLIAD RD
City SAN ANTONIO
State TX
ZIP 78223
Phone 210 533-7602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2023
Certificate Expiration Date 6/8/2025
Facility Type Pharmacy
Lab Director RYAN G. EVANS

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This page was last updated on: 3/20/2025