45D1003967 CLIA NUMBER - RIDGEWOOD MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 45D1003967

Facility Name: RIDGEWOOD MEDICAL CLINIC

Facility Address:
219 W KINGSLEY RD STE 336
GARLAND, TX
ZIP 75041
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Facility Phone Number: 972 271-5544

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1881105724

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	45D1003967
LAB Type	Physician Office
Facility Name	RIDGEWOOD MEDICAL CLINIC
Street	219 W KINGSLEY RD STE 336
City	GARLAND
State	TX
ZIP	75041
Phone	972 271-5544
CertificateType	2
CertificateEffectiveDate	12/13/2022
CertificateExpirationDate	12/12/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024