18D2183977 CLIA NUMBER - MCCONNELL HEALTH MART PHARMACY

Laboratory Demographics

  • CLIA Code: 18D2183977
  • Facility Name: MCCONNELL HEALTH MART PHARMACY
  • Facility Address: 88 CEDAR ST
    KUTTAWA, KY
    ZIP 42055
  • Facility Phone: 270 388-7371
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. EDWIN L. NICKELL
  • NPI Number: 1679553325
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2183977
LAB Type Pharmacy
Facility Name MCCONNELL HEALTH MART PHARMACY
Street 88 CEDAR ST
City KUTTAWA
State KY
ZIP 42055
Phone 270 388-7371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Pharmacy
Lab Director MR. EDWIN L. NICKELL

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