45D2290924 CLIA NUMBER - HEB PHARMACY # 780

Laboratory Demographics

  • CLIA Code: 45D2290924
  • Facility Name: HEB PHARMACY # 780
  • Facility Address: 12021 WEST US 290 BUILDING 1
    AUSTIN, TX
    ZIP 78737
  • Facility Phone: 210 938-2780
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BO DAVIS
  • NPI Number: 1609587245
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2290924
LAB Type Pharmacy
Facility Name HEB PHARMACY # 780
Street 12021 WEST US 290 BUILDING 1
City AUSTIN
State TX
ZIP 78737
Phone 210 938-2780
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Pharmacy
Lab Director BO DAVIS

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