45D2022163 CLIA NUMBER - WALGREENS # 06996

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Laboratory Demographics

CLIA Number: 45D2022163

Facility Name: WALGREENS # 06996

Facility Address:
4200 E LANCASTER AVENUE
FORT WORTH, TX
ZIP 76103
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Facility Phone Number: 817 413-7442

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1770598674

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	45D2022163
LAB Type	Pharmacy
Facility Name	WALGREENS # 06996
Street	4200 E LANCASTER AVENUE
City	FORT WORTH
State	TX
ZIP	76103
Phone	817 413-7442
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024