14D0696803 CLIA NUMBER - MEDICINE SHOPPE OF SALEM

Laboratory Demographics

  • CLIA Code: 14D0696803
  • Facility Name: MEDICINE SHOPPE OF SALEM
  • Facility Address: 215 NORTH BROADWAY
    SALEM, IL
    ZIP 62881
  • Facility Phone: 618 548-0070
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL L. MORTON
  • NPI Number: 1285728691
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D0696803
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE OF SALEM
Street 215 NORTH BROADWAY
City SALEM
State IL
ZIP 62881
Phone 618 548-0070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Pharmacy
Lab Director MICHAEL L. MORTON

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