45D2055671 CLIA NUMBER - WALGREENS #15202

Laboratory Demographics

  • CLIA Code: 45D2055671
  • Facility Name: WALGREENS #15202
  • Facility Address: 2008 W PALMA VISTA DRIVE
    PALMVIEW, TX
    ZIP 78572
  • Facility Phone: 956 583-0580
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NJEMNU FOMUSO
  • NPI Number: 1225317084
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2055671
LAB Type Pharmacy
Facility Name WALGREENS #15202
Street 2008 W PALMA VISTA DRIVE
City PALMVIEW
State TX
ZIP 78572
Phone 956 583-0580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director NJEMNU FOMUSO

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