45D2220264 CLIA NUMBER - WALGREENS #12716

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Laboratory Demographics

CLIA Number: 45D2220264

Facility Name: WALGREENS #12716

Facility Address:
12020 CULEBRA
SAN ANTONIO, TX
ZIP 78253
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Facility Phone Number: 210 762-3040

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1316287949

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	45D2220264
LAB Type	Pharmacy
Facility Name	WALGREENS #12716
Street	12020 CULEBRA
City	SAN ANTONIO
State	TX
ZIP	78253
Phone	210 762-3040
CertificateType	4
CertificateEffectiveDate	4/12/2023
CertificateExpirationDate	4/11/2025
FacilityType	Waiver

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