08D1075438 CLIA NUMBER - ATLANTIC APOTHECARY WELLNESS CLINIC

Laboratory Demographics

  • CLIA Code: 08D1075438
  • Facility Name: ATLANTIC APOTHECARY WELLNESS CLINIC
  • Facility Address: 103 SOUTH DUPONT BLVD, SUITE 2
    SMYRNA, DE
    ZIP 19977
  • Facility Phone: 302 653-9355
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN J. MUSTO
  • NPI Number: 1609065283
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 08D1075438
LAB Type Pharmacy
Facility Name ATLANTIC APOTHECARY WELLNESS CLINIC
Street 103 SOUTH DUPONT BLVD, SUITE 2
City SMYRNA
State DE
ZIP 19977
Phone 302 653-9355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Pharmacy
Lab Director KEVIN J. MUSTO

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