45D1094222 CLIA NUMBER - MARKET STREET PHARMACY #564

Laboratory Demographics

  • CLIA Code: 45D1094222
  • Facility Name: MARKET STREET PHARMACY #564
  • Facility Address: 700 N DENTON TAP ROAD
    COPPELL, TX
    ZIP 75019
  • Facility Phone: (469) 322-6815
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM HERTEL

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CLIA Record

Field Name Field Value
CLIA Number 45D1094222
LAB Type Pharmacy
Facility Name MARKET STREET PHARMACY #564
Street 700 N DENTON TAP ROAD
City COPPELL
State TX
ZIP 75019
Phone 4693226815
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Pharmacy
Lab Director WILLIAM HERTEL

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This page was last updated on: 5/18/2026