45D2215595 CLIA NUMBER - WALGREENS #11274

Laboratory Demographics

  • CLIA Code: 45D2215595
  • Facility Name: WALGREENS #11274
  • Facility Address: 2735 S STATE HIGHWAY 36
    GATESVILLE, TX
    ZIP 76528
  • Facility Phone: 254 865-2089
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AIMEE LUSSON
  • NPI Number: 1427245083
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2215595
LAB Type Pharmacy
Facility Name WALGREENS #11274
Street 2735 S STATE HIGHWAY 36
City GATESVILLE
State TX
ZIP 76528
Phone 254 865-2089
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Pharmacy
Lab Director AIMEE LUSSON

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