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45D1054949 CLIA NUMBER - CLEBURNE DRUG

Laboratory Demographics

CLIA Number: 45D1054949

Facility Name: CLEBURNE DRUG

Facility Address:
310 N RIDGEWAY DR
CLEBURNE, TX
ZIP 76033
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Facility Phone Number: 817 645-2415

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1477705085

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 45D1054949
LAB Type Pharmacy
Facility Name CLEBURNE DRUG
Street 310 N RIDGEWAY DR
City CLEBURNE
State TX
ZIP 76033
Phone 817 645-2415
CertificateType 4
CertificateEffectiveDate 6/6/2022
CertificateExpirationDate 6/5/2024
FacilityType Waiver

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