45D2021968 CLIA NUMBER - WALGREENS #05792

Laboratory Demographics

  • CLIA Code: 45D2021968
  • Facility Name: WALGREENS #05792
  • Facility Address: 102 N TIMBERLAND DR
    LUFKIN, TX
    ZIP 75901
  • Facility Phone: 936 699-2916
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AIMEE LUSSON
  • NPI Number: 1578578555
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2021968
LAB Type Pharmacy
Facility Name WALGREENS #05792
Street 102 N TIMBERLAND DR
City LUFKIN
State TX
ZIP 75901
Phone 936 699-2916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Pharmacy
Lab Director AIMEE LUSSON

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