45D2152559 CLIA NUMBER - KELLY DRUG, INC

Laboratory Demographics

CLIA Number: 45D2152559

Facility Name: KELLY DRUG, INC

Facility Address:
125 E BROAD STREET
MINEOLA, TX
ZIP 75773
Get Directions

Facility Phone Number: 903 569-3882

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467564377

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	45D2152559
LAB Type	Pharmacy
Facility Name	KELLY DRUG, INC
Street	125 E BROAD STREET
City	MINEOLA
State	TX
ZIP	75773
Phone	903 569-3882
CertificateType	4
CertificateEffectiveDate	8/13/2022
CertificateExpirationDate	8/12/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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