45D2015718 CLIA NUMBER - WALGREENS #05434

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Laboratory Demographics

CLIA Number: 45D2015718

Facility Name: WALGREENS #05434

Facility Address:
1621 W HENDERSON ST
CLEBURNE, TX
ZIP 76033
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Facility Phone Number: 817 641-6702

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1861407843

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType	4
CertificateEffectiveDate	3/12/2023
CertificateExpirationDate	3/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024