45D2020841 CLIA NUMBER - WALGREENS #11770

Laboratory Demographics

  • CLIA Code: 45D2020841
  • Facility Name: WALGREENS #11770
  • Facility Address: 2300 E PARK BLVD
    PLANO, TX
    ZIP 75074
  • Facility Phone: 972 422-5123
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATIENCE TANTOH
  • NPI Number: 1619142650
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2020841
LAB Type Pharmacy
Facility Name WALGREENS #11770
Street 2300 E PARK BLVD
City PLANO
State TX
ZIP 75074
Phone 972 422-5123
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 PATIENCE TANTOH

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: 6/4/2025