45D2068310 CLIA NUMBER - WALGREENS #4418

Laboratory Demographics

  • CLIA Code: 45D2068310
  • Facility Name: WALGREENS #4418
  • Facility Address: 313 N DENTON TAP ROAD
    COPPELL, TX
    ZIP 75019
  • Facility Phone: 972 393-9848
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON E. KESSLER
  • NPI Number: 1588679542
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2068310
LAB Type Pharmacy
Facility Name WALGREENS #4418
Street 313 N DENTON TAP ROAD
City COPPELL
State TX
ZIP 75019
Phone 972 393-9848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Pharmacy
Lab Director JASON E. KESSLER

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