45D2214595 CLIA NUMBER - WALGREENS #05274

Laboratory Demographics

  • CLIA Code: 45D2214595
  • Facility Name: WALGREENS #05274
  • Facility Address: 2800 N MESA STREET
    EL PASO, TX
    ZIP 79902
  • Facility Phone: 915 533-6883
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMED JALLAD
  • NPI Number: 1164990768
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2214595
LAB Type Pharmacy
Facility Name WALGREENS #05274
Street 2800 N MESA STREET
City EL PASO
State TX
ZIP 79902
Phone 915 533-6883
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Pharmacy
Lab Director AHMED JALLAD

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