45D2151898 CLIA NUMBER - ROANOKE PHARMACY

Laboratory Demographics

CLIA Number: 45D2151898

Facility Name: ROANOKE PHARMACY

Facility Address:
207 NE BYRON NELSON BLVD
ROANOKE, TX
ZIP 76262
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Facility Phone Number: 817 491-9111

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1679589964

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 45D2151898
LAB Type Pharmacy
Facility Name ROANOKE PHARMACY
Street 207 NE BYRON NELSON BLVD
City ROANOKE
State TX
ZIP 76262
Phone 817 491-9111
CertificateType 4
CertificateEffectiveDate 7/31/2022
CertificateExpirationDate 7/30/2024
FacilityType Waiver

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