45D1072760 CLIA NUMBER - HEB PHARMACY #488

Laboratory Demographics

  • CLIA Code: 45D1072760
  • Facility Name: HEB PHARMACY #488
  • Facility Address: 1600 WILDCAT DRIVE
    PORTLAND, TX
    ZIP 78374
  • Facility Phone: 361 643-1514
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN FERRALL
  • NPI Number: 1215046644
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1072760
LAB Type Pharmacy
Facility Name HEB PHARMACY #488
Street 1600 WILDCAT DRIVE
City PORTLAND
State TX
ZIP 78374
Phone 361 643-1514
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Pharmacy
Lab Director KEVIN FERRALL

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