16D2274752 CLIA NUMBER - MEDICAP PHARMACY 8406

Laboratory Demographics

  • CLIA Code: 16D2274752
  • Facility Name: MEDICAP PHARMACY 8406
  • Facility Address: 1206 S LOCUST ST
    GLENWOOD, IA
    ZIP 51534
  • Facility Phone: 712 527-1200
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MONICA N. NIKSERESHT
  • NPI Number: 1639372055
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2274752
LAB Type Pharmacy
Facility Name MEDICAP PHARMACY 8406
Street 1206 S LOCUST ST
City GLENWOOD
State IA
ZIP 51534
Phone 712 527-1200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Pharmacy
Lab Director MONICA N. NIKSERESHT

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