45D2117668 CLIA NUMBER - TARRYTOWN PHARMACY

Laboratory Demographics

  • CLIA Code: 45D2117668
  • Facility Name: TARRYTOWN PHARMACY
  • Facility Address: 2727 EXPOSITION BLVD STE 105
    AUSTIN, TX
    ZIP 78703
  • Facility Phone: 512 478-6419
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RANNON B. CHING
  • NPI Number: 1265620587
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117668
LAB Type Pharmacy
Facility Name TARRYTOWN PHARMACY
Street 2727 EXPOSITION BLVD STE 105
City AUSTIN
State TX
ZIP 78703
Phone 512 478-6419
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Pharmacy
Lab Director RANNON B. CHING

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