45D2021961 CLIA NUMBER - WALGREENS #11522

Laboratory Demographics

  • CLIA Code: 45D2021961
  • Facility Name: WALGREENS #11522
  • Facility Address: 496 HWY 96 S
    SILSBEE, TX
    ZIP 77656
  • Facility Phone: 409 386-6959
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DORIAN MALOY
  • NPI Number: 1194054338
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2021961
LAB Type Pharmacy
Facility Name WALGREENS #11522
Street 496 HWY 96 S
City SILSBEE
State TX
ZIP 77656
Phone 409 386-6959
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Pharmacy
Lab Director DORIAN MALOY

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