45D2184527 CLIA NUMBER - WALGREENS # 11749

Laboratory Demographics

  • CLIA Code: 45D2184527
  • Facility Name: WALGREENS # 11749
  • Facility Address: 10600 MONTANA AVE
    EL PASO, TX
    ZIP 79935
  • Facility Phone: 915 591-4655
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: AHMED R. JALLAD
  • NPI Number: 1285649293
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2184527
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS # 11749
Street 10600 MONTANA AVE
City EL PASO
State TX
ZIP 79935
Phone 915 591-4655
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director AHMED R. JALLAD

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