45D2196781 CLIA NUMBER - JORDAN PHARMACY, INC

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Laboratory Demographics

CLIA Number: 45D2196781

Facility Name: JORDAN PHARMACY, INC

Facility Address:
107 N RICE
HAMILTON, TX
ZIP 76531
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Facility Phone Number: 254 386-3111

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1578660411

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	45D2196781
LAB Type	Pharmacy
Facility Name	JORDAN PHARMACY, INC
Street	107 N RICE
City	HAMILTON
State	TX
ZIP	76531
Phone	254 386-3111
CertificateType	4
CertificateEffectiveDate	10/20/2022
CertificateExpirationDate	10/19/2024
FacilityType	Waiver

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