45D2183902 CLIA NUMBER - WALGREENS 21464

Laboratory Demographics

  • CLIA Code: 45D2183902
  • Facility Name: WALGREENS 21464
  • Facility Address: 747 HWY 259 NORTH, SUITE 100
    KILGORE, TX
    ZIP 75662
  • Facility Phone: 903 984-8639
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD PIERCE
  • NPI Number: 1346313673
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2183902
LAB Type Physician Office
Facility Name WALGREENS 21464
Street 747 HWY 259 NORTH, SUITE 100
City KILGORE
State TX
ZIP 75662
Phone 903 984-8639
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2024
Certificate Expiration Date 5/11/2026
Facility Type Physician Office
Lab Director RICHARD PIERCE

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