14D0958648 CLIA NUMBER - HARRYS PHARMACY, INC

Laboratory Demographics

  • CLIA Code: 14D0958648
  • Facility Name: HARRYS PHARMACY, INC
  • Facility Address: 620 E JACKSON ST
    AUBURN, IL
    ZIP 62615
  • Facility Phone: 217 438-6141
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SCOTT R. BORNTREGER
  • NPI Number: 1821591207
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D0958648
LAB Type Pharmacy
Facility Name HARRYS PHARMACY, INC
Street 620 E JACKSON ST
City AUBURN
State IL
ZIP 62615
Phone 217 438-6141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Pharmacy
Lab Director SCOTT R. BORNTREGER

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