45D2023614 CLIA NUMBER - WALGREENS #04424

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Laboratory Demographics

CLIA Number: 45D2023614

Facility Name: WALGREENS #04424

Facility Address:
4501 AYERS ST
CORPUS CHRISTI, TX
ZIP 78415
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Facility Phone Number: 361 852-0338

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1922013986

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	45D2023614
LAB Type	Pharmacy
Facility Name	WALGREENS #04424
Street	4501 AYERS ST
City	CORPUS CHRISTI
State	TX
ZIP	78415
Phone	361 852-0338
CertificateType	4
CertificateEffectiveDate	5/3/2023
CertificateExpirationDate	5/2/2025
FacilityType	Waiver

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