45D2022164 CLIA NUMBER - WALGREENS #09015

Laboratory Demographics

  • CLIA Code: 45D2022164
  • Facility Name: WALGREENS #09015
  • Facility Address: 4702 N JIM MILLER ROAD
    DALLAS, TX
    ZIP 75227
  • Facility Phone: 214 388-4951
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANN T. NGUYEN
  • NPI Number: 1164437240
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2022164
LAB Type Pharmacy
Facility Name WALGREENS #09015
Street 4702 N JIM MILLER ROAD
City DALLAS
State TX
ZIP 75227
Phone 214 388-4951
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Pharmacy
Lab Director ANN T. NGUYEN

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