45D2083085 CLIA NUMBER - TOM THUMB PHARMCY #2590

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Laboratory Demographics

CLIA Number: 45D2083085

Facility Name: TOM THUMB PHARMCY #2590

Facility Address:
4112 N JOSEY LN
CARROLLTON, TX
ZIP 75007
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Facility Phone Number: 972 394-3980

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1063441038

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	45D2083085
LAB Type	Pharmacy
Facility Name	TOM THUMB PHARMCY #2590
Street	4112 N JOSEY LN
City	CARROLLTON
State	TX
ZIP	75007
Phone	972 394-3980
CertificateType	4
CertificateEffectiveDate	8/27/2022
CertificateExpirationDate	8/26/2024
FacilityType	Waiver

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