14D2182483 CLIA NUMBER - M AND D PHARMACY, L L C

Laboratory Demographics

  • CLIA Code: 14D2182483
  • Facility Name: M AND D PHARMACY, L L C
  • Facility Address: 201 S STATE ST
    BEARDSTOWN, IL
    ZIP 62618
  • Facility Phone: 217 909-4333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANE M. MILLER
  • NPI Number: 1235506106
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2182483
LAB Type Pharmacy
Facility Name M AND D PHARMACY, L L C
Street 201 S STATE ST
City BEARDSTOWN
State IL
ZIP 62618
Phone 217 909-4333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Pharmacy
Lab Director SHANE M. MILLER

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