45D2072404 CLIA NUMBER - WALGREENS #07892

Laboratory Demographics

  • CLIA Code: 45D2072404
  • Facility Name: WALGREENS #07892
  • Facility Address: 3301 N 4TH STREET
    LONGVIEW, TX
    ZIP 75605
  • Facility Phone: 903 663-4362
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AIMEE LUSSON
  • NPI Number: 1265447346
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2072404
LAB Type Pharmacy
Facility Name WALGREENS #07892
Street 3301 N 4TH STREET
City LONGVIEW
State TX
ZIP 75605
Phone 903 663-4362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director AIMEE LUSSON

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