45D2015718 CLIA NUMBER - WALGREENS #05434

Laboratory Demographics

  • CLIA Code: 45D2015718
  • Facility Name: WALGREENS #05434
  • Facility Address: 1621 W HENDERSON ST
    CLEBURNE, TX
    ZIP 76033
  • Facility Phone: 817 641-6702
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AIMEE LUSSON
  • NPI Number: 1861407843
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2015718
LAB Type Pharmacy
Facility Name WALGREENS #05434
Street 1621 W HENDERSON ST
City CLEBURNE
State TX
ZIP 76033
Phone 817 641-6702
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Pharmacy
Lab Director AIMEE LUSSON

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