45D2021608 CLIA NUMBER - WALGREENS #04632

Laboratory Demographics

  • CLIA Code: 45D2021608
  • Facility Name: WALGREENS #04632
  • Facility Address: 1910 W BRAKER LN
    AUSTIN, TX
    ZIP 78758
  • Facility Phone: 512 837-0819
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID B. HOLLOWAY
  • NPI Number: 1932114923
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2021608
LAB Type Pharmacy
Facility Name WALGREENS #04632
Street 1910 W BRAKER LN
City AUSTIN
State TX
ZIP 78758
Phone 512 837-0819
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director DAVID B. HOLLOWAY

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