24D1099454 CLIA NUMBER - COBORN'S PHARMACY #2016

Laboratory Demographics

  • CLIA Code: 24D1099454
  • Facility Name: COBORN'S PHARMACY #2016
  • Facility Address: 645 LAKE ST S
    LONG PRAIRIE, MN
    ZIP 56347
  • Facility Phone: 320 534-2745
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACY L. JONES
  • NPI Number: 1902480650
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1099454
LAB Type Pharmacy
Facility Name COBORN'S PHARMACY #2016
Street 645 LAKE ST S
City LONG PRAIRIE
State MN
ZIP 56347
Phone 320 534-2745
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2025
Certificate Expiration Date 10/14/2027
Facility Type Pharmacy
Lab Director TRACY L. JONES

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