17D2204723 CLIA NUMBER - AUBURN PHARMACY #140

Laboratory Demographics

  • CLIA Code: 17D2204723
  • Facility Name: AUBURN PHARMACY #140
  • Facility Address: 310 E 15TH ST
    EUDORA, KS
    ZIP 66025
  • Facility Phone: 785 690-7575
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHELSEA R. DOHERTY
  • NPI Number: 1053610105
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2204723
LAB Type Pharmacy
Facility Name AUBURN PHARMACY #140
Street 310 E 15TH ST
City EUDORA
State KS
ZIP 66025
Phone 785 690-7575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Pharmacy
Lab Director CHELSEA R. DOHERTY

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