45D2073514 CLIA NUMBER - WALGREENS # 09721

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Laboratory Demographics

CLIA Number: 45D2073514

Facility Name: WALGREENS # 09721

Facility Address:
1481 E MAIN ST
MIDLOTHIAN, TX
ZIP 76065
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Facility Phone Number: 972 723-8408

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1245245349

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	45D2073514
LAB Type	Pharmacy
Facility Name	WALGREENS # 09721
Street	1481 E MAIN ST
City	MIDLOTHIAN
State	TX
ZIP	76065
Phone	972 723-8408
CertificateType	4
CertificateEffectiveDate	3/8/2023
CertificateExpirationDate	3/7/2025
FacilityType	Waiver

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