45D2072961 CLIA NUMBER - WALGREENS #10872

Laboratory Demographics

  • CLIA Code: 45D2072961
  • Facility Name: WALGREENS #10872
  • Facility Address: 2901 E BROAD ST
    MANSFIELD, TX
    ZIP 76063
  • Facility Phone: 682 518-7219
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN THOMAS
  • NPI Number: 1679588644
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2072961
LAB Type Pharmacy
Facility Name WALGREENS #10872
Street 2901 E BROAD ST
City MANSFIELD
State TX
ZIP 76063
Phone 682 518-7219
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Pharmacy
Lab Director JUSTIN THOMAS

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