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45D2249476 CLIA NUMBER - TOM THUMB PHARMACY #1540

Laboratory Demographics

CLIA Number: 45D2249476

Facility Name: TOM THUMB PHARMACY #1540

Facility Address:
3757 FOREST LANE
DALLAS, TX
ZIP 75234
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Facility Phone Number: 972 241-7442

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1295764264

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 45D2249476
LAB Type Pharmacy
Facility Name TOM THUMB PHARMACY #1540
Street 3757 FOREST LANE
City DALLAS
State TX
ZIP 75234
Phone 972 241-7442
CertificateType 4
CertificateEffectiveDate 1/20/2024
CertificateExpirationDate 1/19/2026
FacilityType Waiver

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