45D1032765 CLIA NUMBER - TOM THUMB PHARMACY #4239

Laboratory Demographics

CLIA Number: 45D1032765

Facility Name: TOM THUMB PHARMACY #4239

Facility Address:
921 S WESTGATE WAY
WYLIE, TX
ZIP 75098
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Facility Phone Number: 972 429-4951

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1760420897

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	45D1032765
LAB Type	Pharmacy
Facility Name	TOM THUMB PHARMACY #4239
Street	921 S WESTGATE WAY
City	WYLIE
State	TX
ZIP	75098
Phone	972 429-4951
CertificateType	4
CertificateEffectiveDate	7/22/2023
CertificateExpirationDate	7/21/2025
FacilityType	Waiver

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