14D2197257 CLIA NUMBER - ALWOOD PHARMACY ILLINI CLINIC PHARMACY

Laboratory Demographics

  • CLIA Code: 14D2197257
  • Facility Name: ALWOOD PHARMACY ILLINI CLINIC PHARMACY
  • Facility Address: 211 S 1ST ST
    ALPHA, IL
    ZIP 61413
  • Facility Phone: 309 629-4508
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DONNA R. MERIDETH
  • NPI Number: 1053838458
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2197257
LAB Type Pharmacy
Facility Name ALWOOD PHARMACY ILLINI CLINIC PHARMACY
Street 211 S 1ST ST
City ALPHA
State IL
ZIP 61413
Phone 309 629-4508
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Pharmacy
Lab Director DONNA R. MERIDETH

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