45D2228289 CLIA NUMBER - WALGREENS #02115

Laboratory Demographics

  • CLIA Code: 45D2228289
  • Facility Name: WALGREENS #02115
  • Facility Address: 10997 FUQUA ST
    HOUSTON, TX
    ZIP 77089
  • Facility Phone: 713 943-9289
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELENAR ETTINOFFE-DUBIQUE
  • NPI Number: 1174538177
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2228289
LAB Type Pharmacy
Facility Name WALGREENS #02115
Street 10997 FUQUA ST
City HOUSTON
State TX
ZIP 77089
Phone 713 943-9289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Pharmacy
Lab Director ELENAR ETTINOFFE-DUBIQUE

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