14D2289014 CLIA NUMBER - CAIN'S DRUG STORE INC

Laboratory Demographics

  • CLIA Code: 14D2289014
  • Facility Name: CAIN'S DRUG STORE INC
  • Facility Address: 1401 N 8TH ST
    VANDALIA, IL
    ZIP 62471
  • Facility Phone: 618 283-0196
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SCOTTY R. BORNTREGER
  • NPI Number: 1568486165
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2289014
LAB Type Pharmacy
Facility Name CAIN'S DRUG STORE INC
Street 1401 N 8TH ST
City VANDALIA
State IL
ZIP 62471
Phone 618 283-0196
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Pharmacy
Lab Director SCOTTY R. BORNTREGER

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