45D2203473 CLIA NUMBER - HILLCREST PHARMACY

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Laboratory Demographics

CLIA Number: 45D2203473

Facility Name: HILLCREST PHARMACY

Facility Address:
1015 HILLCREST DR SUITE B
VERNON, TX
ZIP 76384
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Facility Phone Number: 940 555-2950

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1477164697

Taxonomy: 293D00000X - Physiological Laboratory
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.

CLIA Record

Field Name	Field Value
CLIA Number	45D2203473
LAB Type	Pharmacy
Facility Name	HILLCREST PHARMACY
Street	1015 HILLCREST DR SUITE B
City	VERNON
State	TX
ZIP	76384
Phone	940 555-2950
CertificateType	4
CertificateEffectiveDate	12/3/2022
CertificateExpirationDate	12/2/2024
FacilityType	Waiver

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