45D0954204 CLIA NUMBER - MARKET STREET PHARMACY #543

Laboratory Demographics

  • CLIA Code: 45D0954204
  • Facility Name: MARKET STREET PHARMACY #543
  • Facility Address: 4205 98TH STREET
    LUBBOCK, TX
    ZIP 79423
  • Facility Phone: 806 798-6115
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIANNE COUGHLON
  • NPI Number: 1508042946
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D0954204
LAB Type Pharmacy
Facility Name MARKET STREET PHARMACY #543
Street 4205 98TH STREET
City LUBBOCK
State TX
ZIP 79423
Phone 806 798-6115
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 MARIANNE COUGHLON

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