45D2090608 CLIA NUMBER - WALGREENS 21498

Laboratory Demographics

  • CLIA Code: 45D2090608
  • Facility Name: WALGREENS 21498
  • Facility Address: 502C EAST GOODE STREET, SUITE 2
    QUITMAN, TX
    ZIP 75783
  • Facility Phone: 903 763-1420
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACI GEORGE
  • NPI Number: 1376221861
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2090608
LAB Type Pharmacy
Facility Name WALGREENS 21498
Street 502C EAST GOODE STREET, SUITE 2
City QUITMAN
State TX
ZIP 75783
Phone 903 763-1420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Pharmacy
Lab Director TRACI GEORGE

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