45D2219346 CLIA NUMBER - WALGREENS #11130

Laboratory Demographics

  • CLIA Code: 45D2219346
  • Facility Name: WALGREENS #11130
  • Facility Address: 3802 E ELMS RD
    KILLEEN, TX
    ZIP 76542
  • Facility Phone: 254 680-4009
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AIMEE LUSSON
  • NPI Number: 1821268731
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2219346
LAB Type Pharmacy
Facility Name WALGREENS #11130
Street 3802 E ELMS RD
City KILLEEN
State TX
ZIP 76542
Phone 254 680-4009
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director AIMEE LUSSON

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