26D2001668 CLIA NUMBER - KILGORE'S MEDICAL PHARMACY

Laboratory Demographics

  • CLIA Code: 26D2001668
  • Facility Name: KILGORE'S MEDICAL PHARMACY
  • Facility Address: 1608 CHAPEL HILL ROAD
    COLUMBIA, MO
    ZIP 65203
  • Facility Phone: 573 447-4444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL MAZZOLA
  • NPI Number: 1508202888
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2001668
LAB Type Pharmacy
Facility Name KILGORE'S MEDICAL PHARMACY
Street 1608 CHAPEL HILL ROAD
City COLUMBIA
State MO
ZIP 65203
Phone 573 447-4444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Pharmacy
Lab Director MICHAEL MAZZOLA

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