45D2218578 CLIA NUMBER - WALGREENS #03917

Laboratory Demographics

  • CLIA Code: 45D2218578
  • Facility Name: WALGREENS #03917
  • Facility Address: 922 E KING AVE
    KINGSVILLE, TX
    ZIP 78363
  • Facility Phone: 361 221-9714
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SASHA M. CASANOVA
  • NPI Number: 1801801980
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2218578
LAB Type Pharmacy
Facility Name WALGREENS #03917
Street 922 E KING AVE
City KINGSVILLE
State TX
ZIP 78363
Phone 361 221-9714
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director SASHA M. CASANOVA

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