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45D2217462 CLIA NUMBER - WALGREENS #07964

Laboratory Demographics

CLIA Number: 45D2217462

Facility Name: WALGREENS #07964

Facility Address:
5204 N NAVARRO STREET
VICTORIA, TX
ZIP 77904
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Facility Phone Number: 361 576-5238

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1568609097

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType 4
CertificateEffectiveDate 3/22/2023
CertificateExpirationDate 3/21/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024