45D2042740 CLIA NUMBER - WALGREENS 21497

Laboratory Demographics

  • CLIA Code: 45D2042740
  • Facility Name: WALGREENS 21497
  • Facility Address: 306 STATE HWY 37 SOUTH
    MOUNT VERNON, TX
    ZIP 75457
  • Facility Phone: 903 537-2886
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES I. TREDWAY
  • NPI Number: 1508544842
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2042740
LAB Type Pharmacy
Facility Name WALGREENS 21497
Street 306 STATE HWY 37 SOUTH
City MOUNT VERNON
State TX
ZIP 75457
Phone 903 537-2886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2024
Certificate Expiration Date 6/18/2026
Facility Type Pharmacy
Lab Director JAMES I. TREDWAY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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