45D2215726 CLIA NUMBER - WALGREENS #15904

Laboratory Demographics

  • CLIA Code: 45D2215726
  • Facility Name: WALGREENS #15904
  • Facility Address: 20744 STATE HIGHWAY 46 W
    SPRING BRANCH, TX
    ZIP 78070
  • Facility Phone: 830 438-1123
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH OTTIS
  • NPI Number: 1457738213
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2215726
LAB Type Physician Office
Facility Name WALGREENS #15904
Street 20744 STATE HIGHWAY 46 W
City SPRING BRANCH
State TX
ZIP 78070
Phone 830 438-1123
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director JOSEPH OTTIS

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