17D2182347 CLIA NUMBER - PRICE CHOPPER PHARMACY #39

Laboratory Demographics

  • CLIA Code: 17D2182347
  • Facility Name: PRICE CHOPPER PHARMACY #39
  • Facility Address: 12010 W 63RD ST
    SHAWNEE, KS
    ZIP 66216
  • Facility Phone: 913 268-8150
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL T. HALLIWELL
  • NPI Number: 1710092812
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2182347
LAB Type Pharmacy
Facility Name PRICE CHOPPER PHARMACY #39
Street 12010 W 63RD ST
City SHAWNEE
State KS
ZIP 66216
Phone 913 268-8150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Pharmacy
Lab Director MICHAEL T. HALLIWELL

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