45D2021960 CLIA NUMBER - WALGREENS #07614

Laboratory Demographics

  • CLIA Code: 45D2021960
  • Facility Name: WALGREENS #07614
  • Facility Address: 902 N MAIN ST
    LUMBERTON, TX
    ZIP 77657
  • Facility Phone: 409 755-2858
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UGONWA ONUBOGU
  • NPI Number: 1689689747
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2021960
LAB Type Pharmacy
Facility Name WALGREENS #07614
Street 902 N MAIN ST
City LUMBERTON
State TX
ZIP 77657
Phone 409 755-2858
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director UGONWA ONUBOGU

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