45D2030923 CLIA NUMBER - HEB PHARMACY #631

Laboratory Demographics

  • CLIA Code: 45D2030923
  • Facility Name: HEB PHARMACY #631
  • Facility Address: 3804 US HWY 377
    GRANBURY, TX
    ZIP 76049
  • Facility Phone: 817 579-2512
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CLARENCE RICHARDSON
  • NPI Number: 1417242926
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2030923
LAB Type Pharmacy
Facility Name HEB PHARMACY #631
Street 3804 US HWY 377
City GRANBURY
State TX
ZIP 76049
Phone 817 579-2512
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2025
Certificate Expiration Date 10/6/2027
Facility Type Pharmacy
Lab Director CLARENCE RICHARDSON

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