45D2073000 CLIA NUMBER - WALGREENS 04315

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Laboratory Demographics

CLIA Number: 45D2073000

Facility Name: WALGREENS 04315

Facility Address:
4130 LEGACY DR
PLANO, TX
ZIP 75024
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Facility Phone Number: 972 491-5677

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1306851373

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	45D2073000
LAB Type	Pharmacy
Facility Name	WALGREENS 04315
Street	4130 LEGACY DR
City	PLANO
State	TX
ZIP	75024
Phone	972 491-5677
CertificateType	4
CertificateEffectiveDate	8/14/2023
CertificateExpirationDate	8/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024