45D2091297 CLIA NUMBER - WALGREENS #15012

Laboratory Demographics

  • CLIA Code: 45D2091297
  • Facility Name: WALGREENS #15012
  • Facility Address: 9610 W FM 1097 RD W
    WILLIS, TX
    ZIP 77318
  • Facility Phone: 936 856-4096
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANNE MARIE POWERS
  • NPI Number: 1578831343
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2091297
LAB Type Pharmacy
Facility Name WALGREENS #15012
Street 9610 W FM 1097 RD W
City WILLIS
State TX
ZIP 77318
Phone 936 856-4096
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director ANNE MARIE POWERS

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