17D2026252 CLIA NUMBER - COOPER DRUG, INC

Laboratory Demographics

  • CLIA Code: 17D2026252
  • Facility Name: COOPER DRUG, INC
  • Facility Address: 509 STATE STREET
    AUGUSTA, KS
    ZIP 67010
  • Facility Phone: 316 775-2289
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACOB HADLEY
  • NPI Number: 1104919943
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2026252
LAB Type Pharmacy
Facility Name COOPER DRUG, INC
Street 509 STATE STREET
City AUGUSTA
State KS
ZIP 67010
Phone 316 775-2289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Pharmacy
Lab Director JACOB HADLEY

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