17D2203949 CLIA NUMBER - AUBURN PHARMACY #125

Laboratory Demographics

  • CLIA Code: 17D2203949
  • Facility Name: AUBURN PHARMACY #125
  • Facility Address: 625 MAIN STREET
    MOUND CITY, KS
    ZIP 66056
  • Facility Phone: 319 795-4435
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEASHA ALEXANDER
  • NPI Number: 1508332891
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2203949
LAB Type Pharmacy
Facility Name AUBURN PHARMACY #125
Street 625 MAIN STREET
City MOUND CITY
State KS
ZIP 66056
Phone 319 795-4435
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Pharmacy
Lab Director ALEASHA ALEXANDER

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