45D2183930 CLIA NUMBER - BROOKSHIRE PHARMACY #050

Laboratory Demographics

CLIA Number: 45D2183930

Facility Name: BROOKSHIRE PHARMACY #050

Facility Address:
200 WEST HIGHWAY 80
WHITE OAK, TX
ZIP 75693
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Facility Phone Number: 903 297-9896

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1821161159

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	45D2183930
LAB Type	Pharmacy
Facility Name	BROOKSHIRE PHARMACY #050
Street	200 WEST HIGHWAY 80
City	WHITE OAK
State	TX
ZIP	75693
Phone	903 297-9896
CertificateType	4
CertificateEffectiveDate	5/12/2022
CertificateExpirationDate	5/11/2024
FacilityType	Waiver

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