23D2182829 CLIA NUMBER - COUNTRY MARKET PHARMACY #11

Laboratory Demographics

  • CLIA Code: 23D2182829
  • Facility Name: COUNTRY MARKET PHARMACY #11
  • Facility Address: 1535 MAUMEE STREET
    ADRIAN, MI
    ZIP 49221
  • Facility Phone: 517 265-9162
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT L. GARGOL
  • NPI Number: 1285167635
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2182829
LAB Type Pharmacy
Facility Name COUNTRY MARKET PHARMACY #11
Street 1535 MAUMEE STREET
City ADRIAN
State MI
ZIP 49221
Phone 517 265-9162
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Pharmacy
Lab Director ROBERT L. GARGOL

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