45D2195684 CLIA NUMBER - HEB PHARMACY #772

Laboratory Demographics

  • CLIA Code: 45D2195684
  • Facility Name: HEB PHARMACY #772
  • Facility Address: 4405 114TH STREET
    LUBBOCK, TX
    ZIP 79424
  • Facility Phone: 210 938-2772
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDY BLANTON
  • NPI Number: 1811519044
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2195684
LAB Type Pharmacy
Facility Name HEB PHARMACY #772
Street 4405 114TH STREET
City LUBBOCK
State TX
ZIP 79424
Phone 210 938-2772
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2024
Certificate Expiration Date 10/11/2026
Facility Type Pharmacy
Lab Director BRANDY BLANTON

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