45D2017977 CLIA NUMBER - WALGREENS 04606

Laboratory Demographics

  • CLIA Code: 45D2017977
  • Facility Name: WALGREENS 04606
  • Facility Address: 4100 BOSQUE BLVD
    WACO, TX
    ZIP 76710
  • Facility Phone: 254 751-7215
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEANINE PROUD-FLOOD
  • NPI Number: 1033124078
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2017977
LAB Type Pharmacy
Facility Name WALGREENS 04606
Street 4100 BOSQUE BLVD
City WACO
State TX
ZIP 76710
Phone 254 751-7215
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Pharmacy
Lab Director JEANINE PROUD-FLOOD

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