45D2206609 CLIA NUMBER - MEDICAL MART & DME, LLC (HEALTH PLUS PHARMACY)

Laboratory Demographics

  • CLIA Code: 45D2206609
  • Facility Name: MEDICAL MART & DME, LLC (HEALTH PLUS PHARMACY)
  • Facility Address: 3104 W MILE 5 ROAD, STE 2
    MISSION, TX
    ZIP 78574
  • Facility Phone: 956 424-3535
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM FAT-ANTHONY
  • NPI Number: 1912367335
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2206609
LAB Type Physician Office
Facility Name MEDICAL MART & DME, LLC (HEALTH PLUS PHARMACY)
Street 3104 W MILE 5 ROAD, STE 2
City MISSION
State TX
ZIP 78574
Phone 956 424-3535
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Physician Office
Lab Director WILLIAM FAT-ANTHONY

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