45D2024048 CLIA NUMBER - WALGREENS #04012

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Laboratory Demographics

CLIA Number: 45D2024048

Facility Name: WALGREENS #04012

Facility Address:
6707 W NORTHWEST HWY
DALLAS, TX
ZIP 75225
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Facility Phone Number: 214 361-4637

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1497760466

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	45D2024048
LAB Type	Pharmacy
Facility Name	WALGREENS #04012
Street	6707 W NORTHWEST HWY
City	DALLAS
State	TX
ZIP	75225
Phone	214 361-4637
CertificateType	4
CertificateEffectiveDate	1/25/2024
CertificateExpirationDate	1/24/2026
FacilityType	Waiver

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