45D2017975 CLIA NUMBER - WALGREENS 03909

Laboratory Demographics

  • CLIA Code: 45D2017975
  • Facility Name: WALGREENS 03909
  • Facility Address: 3400 MATLOCK RD
    ARLINGTON, TX
    ZIP 76015
  • Facility Phone: 817 419-0569
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOUL REXSTON
  • NPI Number: 1831427459
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 45D2017975
LAB Type Pharmacy
Facility Name WALGREENS 03909
Street 3400 MATLOCK RD
City ARLINGTON
State TX
ZIP 76015
Phone 817 419-0569
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Pharmacy
Lab Director MOUL REXSTON

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