45D1071540 CLIA NUMBER - HEB PHARMACY #028

Laboratory Demographics

  • CLIA Code: 45D1071540
  • Facility Name: HEB PHARMACY #028
  • Facility Address: 2955 SOUTH GULF FREEWAY
    LEAGUE CITY, TX
    ZIP 77573
  • Facility Phone: 281 337-5210
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAM PHAN
  • NPI Number: 1033228465
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1071540
LAB Type Pharmacy
Facility Name HEB PHARMACY #028
Street 2955 SOUTH GULF FREEWAY
City LEAGUE CITY
State TX
ZIP 77573
Phone 281 337-5210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2023
Certificate Expiration Date 7/26/2025
Facility Type Pharmacy
Lab Director TAM PHAN

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