45D2067959 CLIA NUMBER - WALGREENS #02020

Laboratory Demographics

  • CLIA Code: 45D2067959
  • Facility Name: WALGREENS #02020
  • Facility Address: 912 W NORTHWEST HWY
    GRAPEVINE, TX
    ZIP 76051
  • Facility Phone: 817 310-3072
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTONIO B. GREENE
  • NPI Number: 1992710073
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2067959
LAB Type Pharmacy
Facility Name WALGREENS #02020
Street 912 W NORTHWEST HWY
City GRAPEVINE
State TX
ZIP 76051
Phone 817 310-3072
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Pharmacy
Lab Director ANTONIO B. GREENE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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