25D2184400 CLIA NUMBER - MOORE'S PHARMACY

Laboratory Demographics

  • CLIA Code: 25D2184400
  • Facility Name: MOORE'S PHARMACY
  • Facility Address: 1212 GRAND AVE
    LENA, MS
    ZIP 39094
  • Facility Phone: 601 780-2757
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRETT C. MOORE
  • NPI Number: 1568012383
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2184400
LAB Type Pharmacy
Facility Name MOORE'S PHARMACY
Street 1212 GRAND AVE
City LENA
State MS
ZIP 39094
Phone 601 780-2757
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Pharmacy
Lab Director BRETT C. MOORE

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