45D2196781 CLIA NUMBER - JORDAN PHARMACY, INC

Laboratory Demographics

  • CLIA Code: 45D2196781
  • Facility Name: JORDAN PHARMACY, INC
  • Facility Address: 107 N RICE
    HAMILTON, TX
    ZIP 76531
  • Facility Phone: 254 386-3111
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAN PATTILLO
  • NPI Number: 1578660411
  • Taxonomy: 3336C0003X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Pharmacy
Lab Director JAN PATTILLO

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