45D2060905 CLIA NUMBER - WALGREENS #9697

Laboratory Demographics

  • CLIA Code: 45D2060905
  • Facility Name: WALGREENS #9697
  • Facility Address: 10003 W LOOP 1604 N
    SAN ANTONIO, TX
    ZIP 78254
  • Facility Phone: 210 688-0405
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS MCMILLAN
  • NPI Number: 1972518066
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2060905
LAB Type Pharmacy
Facility Name WALGREENS #9697
Street 10003 W LOOP 1604 N
City SAN ANTONIO
State TX
ZIP 78254
Phone 210 688-0405
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Pharmacy
Lab Director CHRIS MCMILLAN

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