45D2072958 CLIA NUMBER - WALGREENS #09448

Laboratory Demographics

  • CLIA Code: 45D2072958
  • Facility Name: WALGREENS #09448
  • Facility Address: 606 W ENNIS AVE
    ENNIS, TX
    ZIP 75119
  • Facility Phone: 972 875-5996
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BOBBY A. ANYAKWO
  • NPI Number: 1073528154
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2072958
LAB Type Pharmacy
Facility Name WALGREENS #09448
Street 606 W ENNIS AVE
City ENNIS
State TX
ZIP 75119
Phone 972 875-5996
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director BOBBY A. ANYAKWO

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