45D2031678 CLIA NUMBER - WALGREENS # 11672

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Laboratory Demographics

CLIA Number: 45D2031678

Facility Name: WALGREENS # 11672

Facility Address:
1673 HWY 100
PORT ISABEL, TX
ZIP 78578
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Facility Phone Number: 956 943-3754

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053577270

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	45D2031678
LAB Type	Pharmacy
Facility Name	WALGREENS # 11672
Street	1673 HWY 100
City	PORT ISABEL
State	TX
ZIP	78578
Phone	956 943-3754
CertificateType	4
CertificateEffectiveDate	8/2/2023
CertificateExpirationDate	8/1/2025
FacilityType	Waiver

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