45D2022206 CLIA NUMBER - WALGREENS # 05961

Laboratory Demographics

  • CLIA Code: 45D2022206
  • Facility Name: WALGREENS # 05961
  • Facility Address: 921 HENDERSON ST
    FORT WORTH, TX
    ZIP 76102
  • Facility Phone: 817 885-8563
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIA GUILLEN
  • NPI Number: 1669487641
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2022206
LAB Type Pharmacy
Facility Name WALGREENS # 05961
Street 921 HENDERSON ST
City FORT WORTH
State TX
ZIP 76102
Phone 817 885-8563
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Pharmacy
Lab Director MARIA GUILLEN

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