45D2077288 CLIA NUMBER - WALGREENS #9123

Laboratory Demographics

  • CLIA Code: 45D2077288
  • Facility Name: WALGREENS #9123
  • Facility Address: 6905 WESLEY STREET
    GREENVILLE, TX
    ZIP 75402
  • Facility Phone: 903 454-7231
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN F. COOPER
  • NPI Number: 1881609972
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2077288
LAB Type Pharmacy
Facility Name WALGREENS #9123
Street 6905 WESLEY STREET
City GREENVILLE
State TX
ZIP 75402
Phone 903 454-7231
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Pharmacy
Lab Director JUSTIN F. COOPER

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