45D2018004 CLIA NUMBER - WALGREENS #03879

Laboratory Demographics

  • CLIA Code: 45D2018004
  • Facility Name: WALGREENS #03879
  • Facility Address: 3732 W NORTHWEST HWY
    DALLAS, TX
    ZIP 75220
  • Facility Phone: 214 956-0113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN THOMAS
  • NPI Number: 1821003856
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2018004
LAB Type Pharmacy
Facility Name WALGREENS #03879
Street 3732 W NORTHWEST HWY
City DALLAS
State TX
ZIP 75220
Phone 214 956-0113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director JUSTIN THOMAS

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