45D2096962 CLIA NUMBER - HEB PHARMACY #711

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Laboratory Demographics

CLIA Number: 45D2096962

Facility Name: HEB PHARMACY #711

Facility Address:
2501 UNIVERSITY
ODESSA, TX
ZIP 79764
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Facility Phone Number: 432 362-4555

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1962897405

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	45D2096962
LAB Type	Pharmacy
Facility Name	HEB PHARMACY #711
Street	2501 UNIVERSITY
City	ODESSA
State	TX
ZIP	79764
Phone	432 362-4555
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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