45D1072242 CLIA NUMBER - HEB PHARMACY #416

Laboratory Demographics

CLIA Number: 45D1072242

Facility Name: HEB PHARMACY #416

Facility Address:
450 EAST TRAVIS
LA GRANGE, TX
ZIP 78945
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Facility Phone Number: 979 968-8677

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1932216199

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	45D1072242
LAB Type	Pharmacy
Facility Name	HEB PHARMACY #416
Street	450 EAST TRAVIS
City	LA GRANGE
State	TX
ZIP	78945
Phone	979 968-8677
CertificateType	4
CertificateEffectiveDate	8/10/2023
CertificateExpirationDate	8/9/2025
FacilityType	Waiver

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