45D2022643 CLIA NUMBER - WALGREENS #05922

Laboratory Demographics

  • CLIA Code: 45D2022643
  • Facility Name: WALGREENS #05922
  • Facility Address: 108 N E 28TH STREET
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 817 378-0527
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FRANCIS NGUYEN
  • NPI Number: 1932334711
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2022643
LAB Type Pharmacy
Facility Name WALGREENS #05922
Street 108 N E 28TH STREET
City FORT WORTH
State TX
ZIP 76104
Phone 817 378-0527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Pharmacy
Lab Director FRANCIS NGUYEN

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