14D2181704 CLIA NUMBER - AXLINE PHARMACY (01)

Laboratory Demographics

  • CLIA Code: 14D2181704
  • Facility Name: AXLINE PHARMACY (01)
  • Facility Address: 220 N MAIN
    MONMOUTH, IL
    ZIP 61462
  • Facility Phone: 309 734-7019
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MORGAN J. BAIR
  • NPI Number: 1801850276
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2181704
LAB Type Pharmacy
Facility Name AXLINE PHARMACY (01)
Street 220 N MAIN
City MONMOUTH
State IL
ZIP 61462
Phone 309 734-7019
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 MORGAN J. BAIR

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