44D2248608 CLIA NUMBER - TRICARE PHARMACY LLC DBA PRIMECARE PHARMACY

Laboratory Demographics

  • CLIA Code: 44D2248608
  • Facility Name: TRICARE PHARMACY LLC DBA PRIMECARE PHARMACY
  • Facility Address: 710 NASHVILLE PIKE, SUITE 101
    GALLATIN, TN
    ZIP 37066
  • Facility Phone: 615 461-7078
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEOBU PETER
  • NPI Number: 1003166943
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2248608
LAB Type Pharmacy
Facility Name TRICARE PHARMACY LLC DBA PRIMECARE PHARMACY
Street 710 NASHVILLE PIKE, SUITE 101
City GALLATIN
State TN
ZIP 37066
Phone 615 461-7078
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Pharmacy
Lab Director JEOBU PETER

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