45D2151461 CLIA NUMBER - PEACE PHARMACY

Laboratory Demographics

CLIA Number: 45D2151461

Facility Name: PEACE PHARMACY

Facility Address:
300 S BUFFALO STREET
CANTON, TX
ZIP 75103
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Facility Phone Number: 903 567-4129

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1972589430

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	45D2151461
LAB Type	Pharmacy
Facility Name	PEACE PHARMACY
Street	300 S BUFFALO STREET
City	CANTON
State	TX
ZIP	75103
Phone	903 567-4129
CertificateType	4
CertificateEffectiveDate	7/19/2022
CertificateExpirationDate	7/18/2024
FacilityType	Waiver

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