45D2071941 CLIA NUMBER - WALGREENS #3957

Laboratory Demographics

  • CLIA Code: 45D2071941
  • Facility Name: WALGREENS #3957
  • Facility Address: 5101 S LANCASTER RD
    DALLAS, TX
    ZIP 75241
  • Facility Phone: 214 375-7103
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW VILLAVASSO
  • NPI Number: 1902811938
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2071941
LAB Type Pharmacy
Facility Name WALGREENS #3957
Street 5101 S LANCASTER RD
City DALLAS
State TX
ZIP 75241
Phone 214 375-7103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Pharmacy
Lab Director MATTHEW VILLAVASSO

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