45D2056896 CLIA NUMBER - TOM THUMB PHARMACY #3645

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Laboratory Demographics

CLIA Number: 45D2056896

Facility Name: TOM THUMB PHARMACY #3645

Facility Address:
2200 14TH STREET
PLANO, TX
ZIP 75074
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Facility Phone Number: 972 423-4107

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1861421828

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	45D2056896
LAB Type	Pharmacy
Facility Name	TOM THUMB PHARMACY #3645
Street	2200 14TH STREET
City	PLANO
State	TX
ZIP	75074
Phone	972 423-4107
CertificateType	4
CertificateEffectiveDate	4/4/2023
CertificateExpirationDate	4/3/2025
FacilityType	Waiver

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