16D2023542 CLIA NUMBER - KOHLL'S RX

Laboratory Demographics

  • CLIA Code: 16D2023542
  • Facility Name: KOHLL'S RX
  • Facility Address: 403 MAIN STREET
    MALVERN, IA
    ZIP 51551
  • Facility Phone: 402 973-1914
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DENISE R. WHITE
  • NPI Number: 1073088019
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2023542
LAB Type Independent
Facility Name KOHLL'S RX
Street 403 MAIN STREET
City MALVERN
State IA
ZIP 51551
Phone 402 973-1914
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Independent
Lab Director DENISE R. WHITE

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