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45D1072693 CLIA NUMBER - HEB PHARMACY #643

Laboratory Demographics

CLIA Number: 45D1072693

Facility Name: HEB PHARMACY #643

Facility Address:
4444 KOSTORYZ
CORPUS CHRISTI, TX
ZIP 78415
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Facility Phone Number: 210 938-2643

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1912020025

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 45D1072693
LAB Type Pharmacy
Facility Name HEB PHARMACY #643
Street 4444 KOSTORYZ
City CORPUS CHRISTI
State TX
ZIP 78415
Phone 210 938-2643
CertificateType 4
CertificateEffectiveDate 8/22/2023
CertificateExpirationDate 8/21/2025
FacilityType Waiver

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