45D2073209 CLIA NUMBER - WALGREENS #10258

Laboratory Demographics

  • CLIA Code: 45D2073209
  • Facility Name: WALGREENS #10258
  • Facility Address: 201 FM 1821
    MINERAL WELLS, TX
    ZIP 76067
  • Facility Phone: 940 325-6084
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSE VELOSO
  • NPI Number: 1477593747
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2073209
LAB Type Pharmacy
Facility Name WALGREENS #10258
Street 201 FM 1821
City MINERAL WELLS
State TX
ZIP 76067
Phone 940 325-6084
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Pharmacy
Lab Director JOSE VELOSO

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