45D1072282 CLIA NUMBER - HEB PHARMACY #672

Laboratory Demographics

  • CLIA Code: 45D1072282
  • Facility Name: HEB PHARMACY #672
  • Facility Address: 1821 SOUTH VALLEY MILLS DRIVE
    WACO, TX
    ZIP 76711
  • Facility Phone: 254 757-3344
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELTON PECK
  • NPI Number: 1376652719
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1072282
LAB Type Pharmacy
Facility Name HEB PHARMACY #672
Street 1821 SOUTH VALLEY MILLS DRIVE
City WACO
State TX
ZIP 76711
Phone 254 757-3344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2025
Certificate Expiration Date 8/12/2027
Facility Type Pharmacy
Lab Director KELTON PECK

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