45D2291739 CLIA NUMBER - WALGREENS 04836

Laboratory Demographics

  • CLIA Code: 45D2291739
  • Facility Name: WALGREENS 04836
  • Facility Address: 11810 RANCH ROAD 620 N
    AUSTIN, TX
    ZIP 78750
  • Facility Phone: 512 258-2459
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMMY L. TODD
  • NPI Number: 1215942271
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2291739
LAB Type Pharmacy
Facility Name WALGREENS 04836
Street 11810 RANCH ROAD 620 N
City AUSTIN
State TX
ZIP 78750
Phone 512 258-2459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Pharmacy
Lab Director TAMMY L. TODD

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