45D2021600 CLIA NUMBER - WALGREENS #07024

Laboratory Demographics

  • CLIA Code: 45D2021600
  • Facility Name: WALGREENS #07024
  • Facility Address: 801 MAPLE AVE
    ODESSA, TX
    ZIP 79761
  • Facility Phone: 432 337-6637
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMED JALLAD
  • NPI Number: 1942215991
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2021600
LAB Type Pharmacy
Facility Name WALGREENS #07024
Street 801 MAPLE AVE
City ODESSA
State TX
ZIP 79761
Phone 432 337-6637
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director AHMED JALLAD

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