45D2052068 CLIA NUMBER - WALGREENS #15085

Laboratory Demographics

  • CLIA Code: 45D2052068
  • Facility Name: WALGREENS #15085
  • Facility Address: 4400 W GREEN OAKS BLVD
    ARLINGTON, TX
    ZIP 76016
  • Facility Phone: 817 563-0142
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANY PRASAD VATTAKUNNEL
  • NPI Number: 1346509619
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2052068
LAB Type Pharmacy
Facility Name WALGREENS #15085
Street 4400 W GREEN OAKS BLVD
City ARLINGTON
State TX
ZIP 76016
Phone 817 563-0142
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Pharmacy
Lab Director SANY PRASAD VATTAKUNNEL

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