16D2251935 CLIA NUMBER - MOUNT VERNON PHARMACY

Laboratory Demographics

  • CLIA Code: 16D2251935
  • Facility Name: MOUNT VERNON PHARMACY
  • Facility Address: 101 1ST STREET NE
    MOUNT VERNON, IA
    ZIP 52314
  • Facility Phone: (319) 895-6248
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVIDINE JOHNSON
  • NPI Number: 1871687905
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2251935
LAB Type Pharmacy
Facility Name MOUNT VERNON PHARMACY
Street 101 1ST STREET NE
City MOUNT VERNON
State IA
ZIP 52314
Phone 3198956248
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2026
Certificate Expiration Date 2/6/2028
Facility Type Pharmacy
Lab Director DAVIDINE JOHNSON

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This page was last updated on: 5/18/2026