45D2217462 CLIA NUMBER - WALGREENS #07964

Laboratory Demographics

  • CLIA Code: 45D2217462
  • Facility Name: WALGREENS #07964
  • Facility Address: 5204 N NAVARRO STREET
    VICTORIA, TX
    ZIP 77904
  • Facility Phone: 361 576-5238
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BENJAMIN DOUGLAS
  • NPI Number: 1568609097
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2217462
LAB Type Pharmacy
Facility Name WALGREENS #07964
Street 5204 N NAVARRO STREET
City VICTORIA
State TX
ZIP 77904
Phone 361 576-5238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director BENJAMIN DOUGLAS

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