45D2036894 CLIA NUMBER - WALGREENS #09500

Laboratory Demographics

  • CLIA Code: 45D2036894
  • Facility Name: WALGREENS #09500
  • Facility Address: 705 BOYD ROAD
    AZLE, TX
    ZIP 76020
  • Facility Phone: 817 444-2984
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICIA M. DIAZ
  • NPI Number: 1063427151
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2036894
LAB Type Pharmacy
Facility Name WALGREENS #09500
Street 705 BOYD ROAD
City AZLE
State TX
ZIP 76020
Phone 817 444-2984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director PATRICIA M. DIAZ

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