45D2038021 CLIA NUMBER - WALGREENS #9810

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Laboratory Demographics

CLIA Number: 45D2038021

Facility Name: WALGREENS #9810

Facility Address:
1357 E COURT
SEGUIN, TX
ZIP 78155
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Facility Phone Number: 830 372-3360

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1952685737

Taxonomy: 305S00000X - Point of Service
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

CLIA Record

Field Name	Field Value
CLIA Number	45D2038021
LAB Type	Pharmacy
Facility Name	WALGREENS #9810
Street	1357 E COURT
City	SEGUIN
State	TX
ZIP	78155
Phone	830 372-3360
CertificateType	4
CertificateEffectiveDate	3/22/2023
CertificateExpirationDate	3/21/2025
FacilityType	Waiver

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