45D0991063 CLIA NUMBER - MEDICINE SHOPPE 1736

Laboratory Demographics

  • CLIA Code: 45D0991063
  • Facility Name: MEDICINE SHOPPE 1736
  • Facility Address: 2002 GRANT AVE SUITE A
    EL PASO, TX
    ZIP 79930
  • Facility Phone: 915 544-6605
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTHA T. MOSHER
  • NPI Number: 1477647782
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D0991063
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE 1736
Street 2002 GRANT AVE SUITE A
City EL PASO
State TX
ZIP 79930
Phone 915 544-6605
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2023
Certificate Expiration Date 9/10/2025
Facility Type Pharmacy
Lab Director MARTHA T. MOSHER

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This page was last updated on: 6/4/2025