45D2060940 CLIA NUMBER - WALGREENS #03563

Laboratory Demographics

  • CLIA Code: 45D2060940
  • Facility Name: WALGREENS #03563
  • Facility Address: 7103 MARBACH ROAD
    SAN ANTONIO, TX
    ZIP 78227
  • Facility Phone: 210 675-6612
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARY W. IKAMBA
  • NPI Number: 1932394848
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2060940
LAB Type Pharmacy
Facility Name WALGREENS #03563
Street 7103 MARBACH ROAD
City SAN ANTONIO
State TX
ZIP 78227
Phone 210 675-6612
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Pharmacy
Lab Director MARY W. IKAMBA

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