45D2205209 CLIA NUMBER - WALGREENS #10465

Laboratory Demographics

  • CLIA Code: 45D2205209
  • Facility Name: WALGREENS #10465
  • Facility Address: 2105 RUBEN TORRES SR BLVD
    BROWNSVILLE, TX
    ZIP 78526
  • Facility Phone: 956 504-3142
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAI PHAN
  • NPI Number: 1316221872
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2205209
LAB Type Pharmacy
Facility Name WALGREENS #10465
Street 2105 RUBEN TORRES SR BLVD
City BROWNSVILLE
State TX
ZIP 78526
Phone 956 504-3142
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Pharmacy
Lab Director TAI PHAN

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