45D2197278 CLIA NUMBER - LEGENDS PHARMACY II

Laboratory Demographics

  • CLIA Code: 45D2197278
  • Facility Name: LEGENDS PHARMACY II
  • Facility Address: 1602 AVENUE D SUITE 500
    KATY, TX
    ZIP 77493
  • Facility Phone: 281 496-0640
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA DIPAOLO
  • NPI Number: 1972742195
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2197278
LAB Type Pharmacy
Facility Name LEGENDS PHARMACY II
Street 1602 AVENUE D SUITE 500
City KATY
State TX
ZIP 77493
Phone 281 496-0640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Pharmacy
Lab Director ANGELA DIPAOLO

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