45D2059416 CLIA NUMBER - WALGREENS #3634

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Laboratory Demographics

CLIA Number: 45D2059416

Facility Name: WALGREENS #3634

Facility Address:
3326 FREDERICKSBURG ROAD
SAN ANTONIO, TX
ZIP 78201
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Facility Phone Number: 210 732-1621

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1851306807

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	45D2059416
LAB Type	Pharmacy
Facility Name	WALGREENS #3634
Street	3326 FREDERICKSBURG ROAD
City	SAN ANTONIO
State	TX
ZIP	78201
Phone	210 732-1621
CertificateType	4
CertificateEffectiveDate	4/5/2023
CertificateExpirationDate	4/4/2025
FacilityType	Waiver

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