17D2159737 CLIA NUMBER - MAIN STREET PHARMACY

Laboratory Demographics

  • CLIA Code: 17D2159737
  • Facility Name: MAIN STREET PHARMACY
  • Facility Address: 113 EAST MAIN STREET
    COLDWATER, KS
    ZIP 67029
  • Facility Phone: 620 582-2134
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA L. GALES
  • NPI Number: 1407862287
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159737
LAB Type Pharmacy
Facility Name MAIN STREET PHARMACY
Street 113 EAST MAIN STREET
City COLDWATER
State KS
ZIP 67029
Phone 620 582-2134
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2024
Certificate Expiration Date 12/25/2026
Facility Type Pharmacy
Lab Director LISA L. GALES

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