45D2022633 CLIA NUMBER - WALGREEN #09126

Laboratory Demographics

  • CLIA Code: 45D2022633
  • Facility Name: WALGREEN #09126
  • Facility Address: 2602 FORT WORTH AVE
    DALLAS, TX
    ZIP 75211
  • Facility Phone: 214 941-0926
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLUFUNKE G. FOLAYAN
  • NPI Number: 1386651321
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2022633
LAB Type Pharmacy
Facility Name WALGREEN #09126
Street 2602 FORT WORTH AVE
City DALLAS
State TX
ZIP 75211
Phone 214 941-0926
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director OLUFUNKE G. FOLAYAN

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