45D2015680 CLIA NUMBER - WALGREENS #04838

Laboratory Demographics

  • CLIA Code: 45D2015680
  • Facility Name: WALGREENS #04838
  • Facility Address: 19203 STONE OAK PKWY
    SAN ANTONIO, TX
    ZIP 78258
  • Facility Phone: 210 403-0002
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRINA S. WILLIAMS
  • NPI Number: 1407015597
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2015680
LAB Type Pharmacy
Facility Name WALGREENS #04838
Street 19203 STONE OAK PKWY
City SAN ANTONIO
State TX
ZIP 78258
Phone 210 403-0002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Pharmacy
Lab Director TRINA S. WILLIAMS

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