45D2072749 CLIA NUMBER - WALGREENS #12907

Laboratory Demographics

  • CLIA Code: 45D2072749
  • Facility Name: WALGREENS #12907
  • Facility Address: 1600 PRESTON RD
    PLANO, TX
    ZIP 75093
  • Facility Phone: 972 769-9171
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES A. JOHNSON
  • NPI Number: 1588894166
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2072749
LAB Type Pharmacy
Facility Name WALGREENS #12907
Street 1600 PRESTON RD
City PLANO
State TX
ZIP 75093
Phone 972 769-9171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Pharmacy
Lab Director CHARLES A. JOHNSON

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