45D2018013 CLIA NUMBER - WALGREENS #07611

Laboratory Demographics

  • CLIA Code: 45D2018013
  • Facility Name: WALGREENS #07611
  • Facility Address: 511 E MARSHALL AVE
    LONGVIEW, TX
    ZIP 75601
  • Facility Phone: 903 234-9509
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CODY W. GRAHAM
  • NPI Number: 1407860687
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2018013
LAB Type Pharmacy
Facility Name WALGREENS #07611
Street 511 E MARSHALL AVE
City LONGVIEW
State TX
ZIP 75601
Phone 903 234-9509
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Pharmacy
Lab Director CODY W. GRAHAM

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