23D2188654 CLIA NUMBER - DRUG STORE OF IRON MOUNTAIN, THE

Laboratory Demographics

  • CLIA Code: 23D2188654
  • Facility Name: DRUG STORE OF IRON MOUNTAIN, THE
  • Facility Address: 1112 S STEPHENSON AVE
    IRON MOUNTAIN, MI
    ZIP 49801
  • Facility Phone: 906 774-1044
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JORDAN M. MARCHETTI
  • NPI Number: 1811974488
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2188654
LAB Type Pharmacy
Facility Name DRUG STORE OF IRON MOUNTAIN, THE
Street 1112 S STEPHENSON AVE
City IRON MOUNTAIN
State MI
ZIP 49801
Phone 906 774-1044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Pharmacy
Lab Director JORDAN M. MARCHETTI

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