45D2072750 CLIA NUMBER - WALGREENS #4821

Laboratory Demographics

  • CLIA Code: 45D2072750
  • Facility Name: WALGREENS #4821
  • Facility Address: 3404 INDIANA AVE
    LUBBOCK, TX
    ZIP 79413
  • Facility Phone: 806 792-7531
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY P. GHAZIZADEH
  • NPI Number: 1861407801
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2072750
LAB Type Pharmacy
Facility Name WALGREENS #4821
Street 3404 INDIANA AVE
City LUBBOCK
State TX
ZIP 79413
Phone 806 792-7531
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Pharmacy
Lab Director ASHLEY P. GHAZIZADEH

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