10D2228629 CLIA NUMBER - MAGNOLIA PHARMACY

Laboratory Demographics

  • CLIA Code: 10D2228629
  • Facility Name: MAGNOLIA PHARMACY
  • Facility Address: 12525 CURLEY ST
    SAN ANTONIO, FL
    ZIP 33576
  • Facility Phone: 352 588-3330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANNON M. CORKREAN
  • NPI Number: 1841532108
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2228629
LAB Type Pharmacy
Facility Name MAGNOLIA PHARMACY
Street 12525 CURLEY ST
City SAN ANTONIO
State FL
ZIP 33576
Phone 352 588-3330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type Pharmacy
Lab Director SHANNON M. CORKREAN

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