16D2327780 CLIA NUMBER - JEFF LONGSTAFF CORP DBA MEDICAP PHARMACY 8034

Laboratory Demographics

  • CLIA Code: 16D2327780
  • Facility Name: JEFF LONGSTAFF CORP DBA MEDICAP PHARMACY 8034
  • Facility Address: 405 S SUMNER AVE
    CRESTON, IA
    ZIP 50801
  • Facility Phone: 641 782-6558
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEX PETTIT
  • NPI Number: 1447344858
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2327780
LAB Type Pharmacy
Facility Name JEFF LONGSTAFF CORP DBA MEDICAP PHARMACY 8034
Street 405 S SUMNER AVE
City CRESTON
State IA
ZIP 50801
Phone 641 782-6558
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Pharmacy
Lab Director ALEX PETTIT

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