18D0979197 CLIA NUMBER - COLEMANS DRUG STORE INC

Laboratory Demographics

  • CLIA Code: 18D0979197
  • Facility Name: COLEMANS DRUG STORE INC
  • Facility Address: 105 WEST MAIN ST
    STANFORD, KY
    ZIP 40484
  • Facility Phone: 606 365-2164
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALFRED H. PENCE
  • NPI Number: 1386756237
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D0979197
LAB Type Pharmacy
Facility Name COLEMANS DRUG STORE INC
Street 105 WEST MAIN ST
City STANFORD
State KY
ZIP 40484
Phone 606 365-2164
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Pharmacy
Lab Director ALFRED H. PENCE

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