45D2019836 CLIA NUMBER - WALGREENS #21565

Laboratory Demographics

  • CLIA Code: 45D2019836
  • Facility Name: WALGREENS #21565
  • Facility Address: 6991 OLD JACKSONVILLE HIGHWAY, SUITE 101
    TYLER, TX
    ZIP 75703
  • Facility Phone: 903 747-3508
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHELBY ADAMS
  • NPI Number: 1356020986
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2019836
LAB Type Pharmacy
Facility Name WALGREENS #21565
Street 6991 OLD JACKSONVILLE HIGHWAY, SUITE 101
City TYLER
State TX
ZIP 75703
Phone 903 747-3508
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Pharmacy
Lab Director SHELBY ADAMS

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This page was last updated on: 6/4/2025