45D0954200 CLIA NUMBER - AMIGOS PHARMACY #524

Laboratory Demographics

  • CLIA Code: 45D0954200
  • Facility Name: AMIGOS PHARMACY #524
  • Facility Address: 3300 I 40 EAST
    AMARILLO, TX
    ZIP 79103
  • Facility Phone: 806 373-8722
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CODY FRAUSTO
  • NPI Number: 1063499929
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D0954200
LAB Type Pharmacy
Facility Name AMIGOS PHARMACY #524
Street 3300 I 40 EAST
City AMARILLO
State TX
ZIP 79103
Phone 806 373-8722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Pharmacy
Lab Director CODY FRAUSTO

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