45D2017984 CLIA NUMBER - WALGREENS #06195

Laboratory Demographics

  • CLIA Code: 45D2017984
  • Facility Name: WALGREENS #06195
  • Facility Address: 4415 N STATE LINE AVE
    TEXARKANA, TX
    ZIP 75503
  • Facility Phone: 903 792-8918
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KOURTNEY W. SMITH
  • NPI Number: 1578891016
  • Taxonomy: 302R00000X - Health Maintenance Organization

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2017984
LAB Type Pharmacy
Facility Name WALGREENS #06195
Street 4415 N STATE LINE AVE
City TEXARKANA
State TX
ZIP 75503
Phone 903 792-8918
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Pharmacy
Lab Director KOURTNEY W. SMITH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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