45D2174437 CLIA NUMBER - RIO GRANDE PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 45D2174437
  • Facility Name: RIO GRANDE PHARMACY LLC
  • Facility Address: 5500 DONIPHAN DR. STE. 201
    EL PASO, TX
    ZIP 79932
  • Facility Phone: 915 260-8555
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL S. DEMOCK
  • NPI Number: 1659932267
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2174437
LAB Type Pharmacy
Facility Name RIO GRANDE PHARMACY LLC
Street 5500 DONIPHAN DR. STE. 201
City EL PASO
State TX
ZIP 79932
Phone 915 260-8555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Pharmacy
Lab Director DANIEL S. DEMOCK

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