45D2021967 CLIA NUMBER - WALGREENS #07638

Laboratory Demographics

  • CLIA Code: 45D2021967
  • Facility Name: WALGREENS #07638
  • Facility Address: 1250 S WHEELER ST
    JASPER, TX
    ZIP 75951
  • Facility Phone: 409 381-8396
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARAH COWART
  • NPI Number: 1134134042
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2021967
LAB Type Pharmacy
Facility Name WALGREENS #07638
Street 1250 S WHEELER ST
City JASPER
State TX
ZIP 75951
Phone 409 381-8396
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director SARAH COWART

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This page was last updated on: 6/4/2025