14D2181703 CLIA NUMBER - AXLINE PHARMACY (07)

Laboratory Demographics

  • CLIA Code: 14D2181703
  • Facility Name: AXLINE PHARMACY (07)
  • Facility Address: 324 S MCCOY
    GRANVILLE, IL
    ZIP 61326
  • Facility Phone: 815 339-2325
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TONI M. LAWLEY
  • NPI Number: 1407286941
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2181703
LAB Type Pharmacy
Facility Name AXLINE PHARMACY (07)
Street 324 S MCCOY
City GRANVILLE
State IL
ZIP 61326
Phone 815 339-2325
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2024
Certificate Expiration Date 4/8/2026
Facility Type Pharmacy
Lab Director TONI M. LAWLEY

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