45D2224062 CLIA NUMBER - JORDAN PHARMACY

Laboratory Demographics

  • CLIA Code: 45D2224062
  • Facility Name: JORDAN PHARMACY
  • Facility Address: 1332 HWY 16 SOUTH
    GRAHAM, TX
    ZIP 76450
  • Facility Phone: 940 549-1011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JORDAN ROY BRENT
  • NPI Number: 1982817102
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2224062
LAB Type Pharmacy
Facility Name JORDAN PHARMACY
Street 1332 HWY 16 SOUTH
City GRAHAM
State TX
ZIP 76450
Phone 940 549-1011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director JORDAN ROY BRENT

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