45D2072745 CLIA NUMBER - WALGREENS #04267

Laboratory Demographics

  • CLIA Code: 45D2072745
  • Facility Name: WALGREENS #04267
  • Facility Address: 1902 N JUPITER RD
    GARLAND, TX
    ZIP 75042
  • Facility Phone: 972 487-6450
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN THOMAS
  • NPI Number: 1841205804
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2072745
LAB Type Pharmacy
Facility Name WALGREENS #04267
Street 1902 N JUPITER RD
City GARLAND
State TX
ZIP 75042
Phone 972 487-6450
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Pharmacy
Lab Director JUSTIN THOMAS

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