45D1087507 CLIA NUMBER - MARKET STREET PHARMACY #562

Laboratory Demographics

  • CLIA Code: 45D1087507
  • Facility Name: MARKET STREET PHARMACY #562
  • Facility Address: 11999 N DALLAS PARKWAY
    FRISCO, TX
    ZIP 75034
  • Facility Phone: 214 872-1515
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TUAN PHAM
  • NPI Number: 1821253147
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1087507
LAB Type Pharmacy
Facility Name MARKET STREET PHARMACY #562
Street 11999 N DALLAS PARKWAY
City FRISCO
State TX
ZIP 75034
Phone 214 872-1515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Pharmacy
Lab Director TUAN PHAM

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