45D2015793 CLIA NUMBER - WALGREENS # 02636

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Laboratory Demographics

CLIA Number: 45D2015793

Facility Name: WALGREENS # 02636

Facility Address:
2701 N NAVARRO ST
VICTORIA, TX
ZIP 77901
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Facility Phone Number: 361 578-1581

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1508871690

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	45D2015793
LAB Type	Pharmacy
Facility Name	WALGREENS # 02636
Street	2701 N NAVARRO ST
City	VICTORIA
State	TX
ZIP	77901
Phone	361 578-1581
CertificateType	4
CertificateEffectiveDate	5/26/2023
CertificateExpirationDate	5/25/2025
FacilityType	Waiver

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