45D2071324 CLIA NUMBER - WALGREENS #05710

Laboratory Demographics

  • CLIA Code: 45D2071324
  • Facility Name: WALGREENS #05710
  • Facility Address: 18410 PRESTON RD
    DALLAS, TX
    ZIP 75252
  • Facility Phone: 972 599-1004
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN N. COOPER
  • NPI Number: 1023023009
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2071324
LAB Type Pharmacy
Facility Name WALGREENS #05710
Street 18410 PRESTON RD
City DALLAS
State TX
ZIP 75252
Phone 972 599-1004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director JUSTIN N. COOPER

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