26D1086072 CLIA NUMBER - LADUE PHARMACY, LLC

Laboratory Demographics

CLIA Number: 26D1086072

Facility Name: LADUE PHARMACY, LLC

Facility Address:
9832 CLAYTON ROAD
LADUE, MO
ZIP 63124
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Facility Phone Number: 314 993-4031

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1306353354

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	26D1086072
LAB Type	Pharmacy
Facility Name	LADUE PHARMACY, LLC
Street	9832 CLAYTON ROAD
City	LADUE
State	MO
ZIP	63124
Phone	314 993-4031
CertificateType	4
CertificateEffectiveDate	7/3/2022
CertificateExpirationDate	7/2/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024