14D2204065 CLIA NUMBER - MINI THUONG XA PHARMACY INC

Laboratory Demographics

  • CLIA Code: 14D2204065
  • Facility Name: MINI THUONG XA PHARMACY INC
  • Facility Address: 1069 W ARGYLE ST
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: 773 728-1007
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THOA N. BUI
  • NPI Number: 1659425577
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2204065
LAB Type Pharmacy
Facility Name MINI THUONG XA PHARMACY INC
Street 1069 W ARGYLE ST
City CHICAGO
State IL
ZIP 60640
Phone 773 728-1007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Pharmacy
Lab Director THOA N. BUI

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