45D1016765 CLIA NUMBER - MARKET STREET PHARMACY #560

Laboratory Demographics

  • CLIA Code: 45D1016765
  • Facility Name: MARKET STREET PHARMACY #560
  • Facility Address: 5605 COLLEYVILLE BLVD
    COLLEYVILLE, TX
    ZIP 76034
  • Facility Phone: 817 577-5030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID THOMPSON
  • NPI Number: 1073651162
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1016765
LAB Type Pharmacy
Facility Name MARKET STREET PHARMACY #560
Street 5605 COLLEYVILLE BLVD
City COLLEYVILLE
State TX
ZIP 76034
Phone 817 577-5030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Pharmacy
Lab Director DAVID THOMPSON

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