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45D1105094 CLIA NUMBER - TOM THUMB PHARMACY #3623

Laboratory Demographics

CLIA Number: 45D1105094

Facility Name: TOM THUMB PHARMACY #3623

Facility Address:
210 E PLEASANT RUN ROAD
DESOTO, TX
ZIP 75115
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Facility Phone Number: 972 274-7008

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1083650618

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 45D1105094
LAB Type Pharmacy
Facility Name TOM THUMB PHARMACY #3623
Street 210 E PLEASANT RUN ROAD
City DESOTO
State TX
ZIP 75115
Phone 972 274-7008
CertificateType 4
CertificateEffectiveDate 3/27/2024
CertificateExpirationDate 3/26/2026
FacilityType Waiver

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