45D2154895 CLIA NUMBER - WALGREENS 21535

Laboratory Demographics

  • CLIA Code: 45D2154895
  • Facility Name: WALGREENS 21535
  • Facility Address: 3828 TROUP HWY, SUTIE 101
    TYLER, TX
    ZIP 75703
  • Facility Phone: 903 581-9666
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LUCAS BOZICK
  • NPI Number: 1275212813
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2154895
LAB Type Pharmacy
Facility Name WALGREENS 21535
Street 3828 TROUP HWY, SUTIE 101
City TYLER
State TX
ZIP 75703
Phone 903 581-9666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Pharmacy
Lab Director LUCAS BOZICK

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This page was last updated on: 3/20/2025